Registration - PREP - St. Bede the Venerable Catholic Church

Name of Student (First name, middle, last name) REQUIRED Please fill out this field. Please enter valid data.

Family 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.

Family E-mail REQUIRED Please fill out this field. Please enter an email address.

Sex Male Female

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Attending REQUIRED Please fill out this field. Please enter valid data.

Grade Level Entering in the Fall 2023 REQUIRED PK-K 1 2 3 4 5 6 Please fill out this field.

Sacraments Received REQUIRED Baptism First Reconciliation First Communion None Please fill out this field.

Church of Baptism St. Bede Other Catholic Parish Other Non Catholic Church

Date of Baptism Please enter a date.

If Other than St. Bede, Please Provide Name of Parish/Church Please enter valid data.

Address of Parish/Church Where Baptized 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.

If Not Baptized in the Catholic Faith, Please Specify Which Religion:

Date of First Reconciliation Please enter a date.

If Other than St. Bede, Please Provide Name and Address Where 1st Reconciliation was Received

Date of First Communion Please enter a date.

If Other than St. Bede, Please List Name and Address Where 1st Communion was Received

2023-2024 Program Requested PREP Sunday PREP Home Study (Gr. 3 to 6 only)

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