CFM Student Enrollment form: please complete one form for each student.

STUDENT NAME: _________________________________________ GRADE FOR 2008-2009: _______ SEX: _____

CFM 2008-2009 GRADE: _____ Circle CFM Ministry Below:

                              Wed K-5    -    Sun 3-4 yrs    -    Sun Family Program  

                               The Edge 6th, 7th & 8th Grades    -    Life Teen 9th-12th Grades   -    Confirmation 11th Grade
                                                                                                                                      (If one year of Life Teen is completed)
                                                                                                                                                                                                                                                                                                                                                                                       

RELIGION:                   SCHOOL:                                              ATTENDED HERE BEFORE:   Y   N

BIRTH DATE: ___/___/___

SACRAMENT:                    Date:             Place Received:                                   Address of Baptismal Parish:

Baptism:                       /           /          ______________________________    __________________________

1st Communion:           /           /           ______________________________    

1st Reconciliation         /           /           ______________________________     

Confirmation                /           /           ______________________________   

PARENTS PLEASE SIGN:

I the event of an emergency, I hereby authorize St. Joseph CFM staff to transport my child to a hospital for

emergency medical or surgical treatment.

Date: ____________________  Signature of Parent/Guardian:___________________________________________

SPECIAL EDUCATION NEEDS:

Medical Condition:____________________________________________________________________________________

Physical Handicap:____________________________________________________________________________________

Behavioral/Learning Disabilities:_______________________________________________________________________