Instructions
Please choose which class you would prefer for each child. If you cannot register your child, it means your first choice class is full. Please select another class option that is open.
Student Rate
Rate per Student: $50.00
Additional Fees
Name
Start Grade
End Grade
Amount each Student
First Communion
2
2
$30.00
Confirmation
10
10
$30.00
Head of Household
Title
None
Mr.
Ms.
Mrs.
Dr.
* First Name
* Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Relationship
Child
Foster Child
Grandchild
Head
Other
Parent
Spouse
* Gender
Male
Female
Marital Status
Annulment
Church Marriage
Divorced
Engaged
Married
Priest
Remarried
Separated
Single
Widowed
Phone 1
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Phone 2
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Spouse
Title
None
Mr.
Ms.
Mrs.
Dr.
First Name
Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Relationship
Child
Foster Child
Grandchild
Head
Other
Parent
Spouse
Gender
Male
Female
Marital Status
Annulment
Church Marriage
Divorced
Engaged
Married
Priest
Remarried
Separated
Single
Widowed
Phone 1
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Phone 2
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Family Street Address
* Line 1
Line 2
* City
* State
Alabama (AL)
Alaska (AK)
American Samoa (AS)
Arizona (AZ)
Arkansas (AR)
California (CA)
Colorado (CO)
Connecticut (CT)
Delaware (DE)
District of Columbia (DC)
Federated States of Micronesia (FM)
Florida (FL)
Georgia (GA)
Guam (GU)
Hawaii (HI)
Idaho (ID)
Illinois (IL)
Indiana (IN)
Iowa (IA)
Kansas (KS)
Kentucky (KY)
Louisiana (LA)
Maine (ME)
Marshall Islands (MH)
Maryland (MD)
Massachusetts (MA)
Michigan (MI)
Minnesota (MN)
Mississippi (MS)
Missouri (MO)
Montana (MT)
Nebraska (NE)
Nevada (NV)
New Hampshire (NH)
New Jersey (NJ)
New Mexico (NM)
New York (NY)
North Carolina (NC)
North Dakota (ND)
Northern Mariana Islands (NP)
Ohio (OH)
Oklahoma (OK)
Oregon (OR)
Palau (PW)
Pennsylvania (PA)
Puerto Rico (PR)
Rhode Island (RI)
South Carolina (SC)
South Dakota (SD)
Tennessee (TN)
Texas (TX)
Utah (UT)
Vermont (VT)
Virgin Islands (VI)
Virginia (VA)
Washington (WA)
West Virginia (WV)
Wisconsin (WI)
Wyoming (WY)
Alberta (AB)
British Columbia (BC)
Manitoba (MB)
New Brunswick (NB)
Newfoundland and Labrador (NL)
Northwest Territories (NT)
Nova Scotia (NS)
Nunavut (NU)
Prince Edward Island (PE)
Saskatchewan (SK)
Ontario (ON)
Quebec (QC)
Yukon (YT)
Other
* ZIP
Family Phone Numbers
* Primary
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
-
Unlisted
Other
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
-
Unlisted
Family Email Address
* Email
Personal
Unlisted
Send Email Instead of Mail When Possible
Fee Total = $0.00
Family Remarks
Remarks
Enroll Student 1 Do Not Enroll Student 1
Student 1
Type
Head of Household
Spouse
Adult
Young Adult
Child
Other
* First Name
* Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Middle Name
Nickname
Relationship
Child
Foster Child
Grandchild
Head
Other
Parent
Spouse
Birth Date
* Gender
Male
Female
* Grade/Degree
Kindergarten
1
2
3
4
5
6
7
8
9
10
Language
English
English/German
English/Italian
English/Lebanese
English/Other
English/Polish
English/Spanish
German/English
Italian
Machinist
Polish
Spanish
Sub-Teacher
Sacraments
Name
Received
Date
Place
Baptism
Yes
No
MM
01
02
03
04
05
06
07
08
09
10
11
12
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
Annunciation Church Ilion, N.Y.
Blessed Sacrament Utica, N.Y.
Blessed Sacrament , Rochester, NY
Blessed Sacrament Syracuse
Cathedral of the Immaculate Conception Syracuse, NY
Church of Annunciation Clark Mills, NY
Church of St. John the Baptist Rome, NY
Church of St. Rosalie Hampton Bays
Church of the Assumption of the Blessed Virgin Mary Middleburg, VT.
Church of the Holy Family
Historic Old St. John's Church, Utica, NY Utica, NY 13501
Holy Trinity
Holy Trinity Dunkirk, Ny
Methodist
Mother of Divine Grace
Mother of Divine Grace – cheektowaga, NY
Mt. Carmal, Albany, N.Y.
newman center
Orthodox
Other
Our Lady of Lourdes Church Utica, NY 13502
Our Lady of Pompei Syracuse, NY
Our Lady of the Rosary Church New Hartford 13413
Our Lady Queen of the Apostles Frankfort, N.Y.
Received Into Cath Church
Received Into Catholic Church
Received into Church 12/19/98
Received into Church 12/5/98
Received Into Church 2005
Received into Church 4/10/99
Received into the Catholic Center of Utica College.
Sacred Heart Cicero, NY
Sacred Heart Church Yonkers, NY
Sacred Heart/St. Mary's New York Mills, N.Y.
Saint Louis Gonzaga Church Utica, N.Y.
Santo, Yosef North Sumarra, Indonesia
st anthony of Padula Church Utica, NY
St anthony/St Patricks
st anthony's chadwicks
st anthony's church Herkimer, NY
St Edward The Confessor
St James Westfield
St John Chrysostom Church West Roxbury
St John Fisher Boothwyn
st mary of Mount Carmel/ Blessed Sacrament Utica, NY
st mary's New York Mills, NY
st mary's clinton
st mary's Metropolitan Church, Kerala, India
st michael's Church Canfield
st Thomas
St. Agnes Church Utica, NY
St. Anne's Church Whitesboro 13492
St. Anthony of Padua Church Utica
St. Anthony/Agnes Utica, NY
St. Barnabas
St. Bernard Rockville
St. Bernard's Church Waterville, N.Y.
St. Charles Church Philadelphia, PA 19146
St. Christopher Statan Island, NY
St. Francis de Sales Utica, N.Y.
St. Francis of Assisi Sefner
St. George's, New Haven
St. Helena's Sherrill, N.Y.
St. Isidore Parish Bloomingdale, Illinois
St. John The Baptist Church Whitehall
St. John The Evangelist Church
St. John the Evangelist Church New Hartford, NY 13413
St. John, North Bay
St. John's- Newman Center
St. Joseph R C Church Ronkonkoma
St. Joseph/St. Patrick's Church, Utica, NY
St. Joseph's Chester, Vermont
St. Joseph's Church Lee Center, N.Y.
St. Jude's Church Chalfont
St. Marianne Cope Henrietta, Ny
St. Mark's Church Utica, NY
St. Mary of Mt. Carmel/Blessed Sacarament, Utica
St. Mary's Clinton, NY
St. Mary's church
St. Mary's Church Immaculate Wilkes Barre, PA 18701
St. Matthew's Church E Syracuse, NY
St. Patrick's Church Clayville, NY 13322
St. Patricks, Chadwicks Chadwicks, N.Y.
St. Patricks, Clayville
St. Paul's Catholic Church Whitesboro
St. Peters Rome, NY
St. Robert Bellarmine Warrington
St. Thomas Church, New Hartford New Hartford, NY
St. Thomas More New York
Sudbury United Methodist Sudbury
Transfuguration Church Rome, N.Y
Utica College
Whitesboro Presbyterian Whitesboro, NY 13492
Fee Total = $0.00
* Class Choices
* Class 1
Student Remarks
Health Problems
Other Conditions
Misc. Information
Student Contact 1
Title
None
Mr.
Ms.
Mrs.
Dr.
First Name
Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Relationship
Child
Foster Child
Grandchild
Head
Other
Parent
Spouse
Phone Numbers
Primary
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Other
Dad Cell
Dad Work
Emergency
Home
Mom Cell
Mom Work
( )
–
Unlisted
Email Address
Email
Send Email Instead of Mail When Possible