Welcome to Assumption of The Blessed Virgin Mary Catholic Church and our online
 Family Faith Formation Registration platform for Assumption Parish and Immaculate
 Conception Parish families. Please visit our web site at
 http://stmaryassumptionparish.org/conc/family-faith-formation/ for more information.

Click Submit Form to send this information to Assumption Church.

*Required fields

Instructions Registration Fee is $150.00 for 1 Child or $250.00 for 2 or more children. Please send check payable to Assumption Church at 195 S. Kankakee Street, Coal City, IL 60416. Credit Card payments can be made at the parish office during normal office hours.
You may also pay Religious Ed through our electronic giving program - please click here for more information. https://giving.ncsservices.org/g3/

Student 1   Type  
Title *First Name *Last Name Suffix
Relationship   Middle Name   Nickname
Ethnicity   Birth Date *Gender Female   Male
Grade/Degree   Language Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Phone 3 ( ) - Unlisted
  Email 1   Unlisted
  Email 2   Unlisted
Sacraments   Name Received Date Place
   Baptism
   Penance/Reconcilitation
   First Communion
   Confirmation
*Class Choices
*Class 1
Student Remarks
  Health Problems
  Other Conditions
  Misc. Information

Student 1\'s Contact 1
Title   First Name   Last Name Suffix
  Relationship
Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Primary ( ) - Unlisted
  Other ( ) - Unlisted
Email Address
  Email

Student Contact 2
Title   First Name   Last Name Suffix
  Relationship
Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Primary ( ) - Unlisted
  Other ( ) - Unlisted
Email Address
  Email

Family Options  New Family  Update Existing Family  - ID/Env 

Head of Household
Title *First Name *Last Name Suffix
Relationship   Middle Name   Nickname Maiden Name
Ethnicity   Birth Date *Gender Female   Male
Grade/Degree   Language Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1   Unlisted
  Email 2   Unlisted

Spouse
Title   First Name   Last Name Suffix
Relationship   Middle Name   Nickname Maiden Name
Ethnicity   Birth Date   Gender Female   Male
Grade/Degree   Language Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1   Unlisted
  Email 2   Unlisted

Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP

Family Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Family Email Address
*Email   Unlisted


Click Submit Form to send this information to Assumption Church.

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