St. John Vianney Church
CCD Registration
Family Information
Please use proper upper/lower case for all fields.
Names will appear on class rosters, attendance sheets, etc. as entered here.
Family Name:
(Last Name Only!!)
Family Name is required field.
Family Phone:
(10 numeric digits)
Family Phone is a required field
Phone Number must be 10 numeric digits
MUST USE THIS PHONE NUMBER FOR ALL STUDENTS IN FAMILY!!
Address 1:
Address 1 is a required field
Address 2:
City:
City is a required field
State:
MD
DC
VA
State is required field
Zip Code:
Zip Code is a required field
Zip Code must be 5 numeric digits
Primary E-mail:
Primary Email Required
Not a valid E-mail address.
Re-enter Primary Email:
Primary Email Required
Not a valid E-mail address
Secondary E-mail:
Not a valid E-mail address
Re-enter Secondary Email:
Not a valid E-mail address
Family Registered at SJV:
Yes
No
required field
Plesae enter the following information as appropriate for your household.
Father/Guardian
Mother/Guardian
First Name:
First Name:
Last Name:
Maiden Name:
Religion:
Last Name:
Cell Phone:
Must be 10 numeric digits
Religion:
Cell Phone:
Must be 10 numeric digits
Please check your information before submitting.