St. Joseph the Worker &
Holy Family Parish

Loyola Sacrament Registration

- Faith Formation

Online Registration Form
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- Our student(s) is in REQUIRED 2nd Grade Sacraments 9th Grade (1st yr) Confirmation 10th Grade (2nd yr) Confirmation Please fill out this field.
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Parent's Last Name (if different than Students) Please enter valid data.
- Mailing Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Mother's Cell Please enter a phone number.
- Father's Cell Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Best way to contact: REQUIRED Call Email Text Message Please fill out this field.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Address (if different than above) Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Religion Please enter valid data.
- Occupation Please enter valid data.
- Mother's Name REQUIRED Please fill out this field. Please enter valid data.
- Address (if different than above) Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Religion Please enter valid data.
- Occupation Please enter valid data.
- Child(ren) lives with (check all that apply): Mother Father and a step parent
- I grant permission for photos or video of the minor(s) listed below to be used for public display as the church deems fit (bulletin, website, newsletter or other means). REQUIRED Yes No Please fill out this field.
- Number of CHILDREN Attending REQUIRED Please fill out this field.
  
  Student 1
  
  Full Name of Student REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Grade (2020-21) REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Date of BIRTH REQUIRED Please fill out this field. Please enter valid data.
  
  Check the sacraments your child has received: REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  If your child(ren) has any physical, emotional or education needs, please let us know so that we can provide the best possible service for Him/Her):
  
  Student 2
  
  Full Name of Student REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Grade (2020-21) REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Date of BIRTH REQUIRED Please fill out this field. Please enter valid data.
  
  Check the sacraments your child has received: REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  If your child(ren) has any physical, emotional or education needs, please let us know so that we can provide the best possible service for Him/Her):
  
  Student 3
  
  Full Name of Student REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Grade (2020-21) REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Date of BIRTH REQUIRED Please fill out this field. Please enter valid data.
  
  Check the sacraments your child has received: REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  If your child(ren) has any physical, emotional or education needs, please let us know so that we can provide the best possible service for Him/Her):
  
  Student 4
  
  Full Name of Student REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Grade (2020-21) REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Date of BIRTH REQUIRED Please fill out this field. Please enter valid data.
  
  Check the sacraments your child has received: REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  If your child(ren) has any physical, emotional or education needs, please let us know so that we can provide the best possible service for Him/Her):
Submit

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Tuition Fee: 2nd Grade Sacraments - $35 per student (books & banner)
9th and 10th Grade Confirmation - $15 per student (program materials)
Click here to pay online: Online Payment Portal