St Ann Roman Catholic Church

"To Grow In Grace Through Jesus Christ"

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PREP 2021-2022 Registration Form

- Education

St. Ann Parish PREP Registration 2021-2022
April 26th - June 14
- Please complete the registration form below. Payments may be made at the end of the form by check or credit card. Cash or check payments, made out to St. Ann Parish, may be mailed or dropped off to the Parish Office at 502 S. Main Street, Phoenixville, PA 19460. If payment is not made at the time of registration, you will receive an email reminder with a link for payment.
- Only one form is needed per family. You will be prompted for the number of children you are registering.
- Tuition rates for 2021-2022 are as follows: $130 for one child, $220 for two children, and $300 for three or more children.
- If registering a child for the first time, you must send the following to the Parish office:
  - A copy of the child's Baptismal Certificate if the child was not baptized in St. Ann Parish.
  - A copy of the child's First Penance and/or First Communion certificates, if applicable.
  - Information from a prior Religious Education Program, Parish or Regional Catholic School, or Catholic Academy if your child is entering level two or above
God bless you and your families!
Mrs. Julie Prichett
Director of PREP and Youth Sacramental Preparation Coordinator (D/CRE)
youthstann@comcast.net 610-755-1077
St. Ann Parish, 502 S. Main Street, Phoenixville, PA 19460
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- Family Name (Last Name) REQUIRED Please fill out this field. Please enter valid data.
- Home Parish REQUIRED Please fill out this field. Please enter valid data.
- Family Email (on which you will see and read all PREP communications) REQUIRED Please fill out this field. Please enter an email address.
- Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Street 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.
- Father's information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Father is... REQUIRED Living Deceased Please fill out this field.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Mother's information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
- Mother is... REQUIRED Living Deceased Please fill out this field.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Emergency contact information
  (This individual has permission to retrieve my child from PREP in the event of a medical emergency.)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship REQUIRED Please fill out this field. Please enter valid data.
- Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Please supply all requested information. For first time registrations, please mail/email one copy of each child's Baptismal Cerificate if not baptized at St. Ann's to the D/CRE.
- Number of Children you are registering REQUIRED
  number of children
  Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Last PREP level completed REQUIRED Please fill out this field. Please enter valid data.
  
  Name of day school and school grade starting Fall 2021 REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date and Parish REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance Date and Parish Please enter valid data.
  
  1st Communion Date and Parish Please enter valid data.
  
  Medical Conditions/Allergies Please enter valid data.
  
  Prescribed Medications Please enter valid data.
  
  Disability/Learning Support Services Please enter valid data.
  
  G/IEP or 504 REQUIRED Yes No Please fill out this field.
  
  If you answered "yes" to G/IEP or 504 then please also complete and mail a detailed Child Information Form, available through the D/CRE.
  
  Are your child's vaccinations up to date? REQUIRED Yes No Please fill out this field.
  
  If no, has he/she received an exemption from from your current school district? Yes No
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Last PREP level completed REQUIRED Please fill out this field. Please enter valid data.
  
  Name of day school and school grade starting Fall 2021 REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date and Parish REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance Date and Parish Please enter valid data.
  
  1st Communion Date and Parish Please enter valid data.
  
  Medical Conditions/Allergies Please enter valid data.
  
  Prescribed Medications Please enter valid data.
  
  Disability/Learning Support Services Please enter valid data.
  
  G/IEP or 504 REQUIRED Yes No Please fill out this field.
  
  If you answered "yes" to G/IEP or 504 then please also complete and mail a detailed Child Information Form, available through the D/CRE.
  
  Are your child's vaccinations up to date? REQUIRED Yes No Please fill out this field.
  
  If no, has he/she received an exemption from from your current school district? Yes No
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Last PREP level completed REQUIRED Please fill out this field. Please enter valid data.
  
  Name of day school and school grade starting Fall 2021 REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date and Parish REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance Date and Parish Please enter valid data.
  
  1st Communion Date and Parish Please enter valid data.
  
  Medical Conditions/Allergies Please enter valid data.
  
  Prescribed Medications Please enter valid data.
  
  Disability/Learning Support Services Please enter valid data.
  
  G/IEP or 504 REQUIRED Yes No Please fill out this field.
  
  If you answered "yes" to G/IEP or 504 then please also complete and mail a detailed Child Information Form, available through the D/CRE.
  
  Are your child's vaccinations up to date? REQUIRED Yes No Please fill out this field.
  
  If no, has he/she received an exemption from from your current school district? Yes No
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Last PREP level completed REQUIRED Please fill out this field. Please enter valid data.
  
  Name of day school and school grade starting Fall 2021 REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date and Parish REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance Date and Parish Please enter valid data.
  
  1st Communion Date and Parish Please enter valid data.
  
  Medical Conditions/Allergies Please enter valid data.
  
  Prescribed Medications Please enter valid data.
  
  Disability/Learning Support Services Please enter valid data.
  
  G/IEP or 504 REQUIRED Yes No Please fill out this field.
  
  If you answered "yes" to G/IEP or 504 then please also complete and mail a detailed Child Information Form, available through the D/CRE.
  
  Are your child's vaccinations up to date? REQUIRED Yes No Please fill out this field.
  
  If no, has he/she received an exemption from from your current school district? Yes No
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Last PREP level completed REQUIRED Please fill out this field. Please enter valid data.
  
  Name of day school and school grade starting Fall 2021 REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date and Parish REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance Date and Parish Please enter valid data.
  
  1st Communion Date and Parish Please enter valid data.
  
  Medical Conditions/Allergies Please enter valid data.
  
  Prescribed Medications Please enter valid data.
  
  Disability/Learning Support Services Please enter valid data.
  
  G/IEP or 504 REQUIRED Yes No Please fill out this field.
  
  If you answered "yes" to G/IEP or 504 then please also complete and mail a detailed Child Information Form, available through the D/CRE.
  
  Are your child's vaccinations up to date? REQUIRED Yes No Please fill out this field.
  
  If no, has he/she received an exemption from from your current school district? Yes No
- Custody: Are there any custody/legal issues? REQUIRED Yes No Please fill out this field.
- If "yes", please mail/email a complete copy of the latest court order to the D/CRE.
- Name of person responsible for Religious Education if NOT Parent/Guardian. Parent/Guardian must mail a signed, dated letter of permission which is to be kept on file and updated annually.
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship Please enter valid data.
- I give permission for my child's name and picture to appear on parish websites, bulletins, sacramental programs, and related media in relation to events that happen in the program. REQUIRED Yes No Please fill out this field.
- I have read the Religious Education Program Handbook (on parish website) and agree to the program requirements and expectations. REQUIRED Yes No Please fill out this field.
- I give permission that, in my absence, my children who are participating in PREP, may receive emergency medical care for injuries and all situations that should occur while participating in the religious education programs and activities. REQUIRED Yes No Please fill out this field.
- By typing my signature I agree that the above information is accurate and true to the best of my knowledge and that I am the legal parent and/or guardian of the children I am registering for St. Ann Parish PREP.
- Parent/Guardian Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter a date.
- Family Tuition Rates REQUIRED 130.0 – one child 220.0 – two children 300.0 – three or more children Please fill out this field.
Total:

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