Enrollment Form

Parent Information

• Father's First and Last Name:
• Mother's First and Last Name:
• Home Address:
  Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabwe
• Phone Number:
• Email
• Are you an active member of HNJ?
  YesNo
• Day and time you attend mass? Please select8:15 am Tuesday or Friday6:00 pm Wednesday4:30 pm Saturday8:00 am Sunday9:45 am Sunday11:30 am SundayI don't attend mass

 

Emergency Contact Information:

• First and Last Name:
• Phone Number:
• Relationship:

 

Tuition:

• Active Parishioners
  $ 80.00 Per student per year
• Non-Members
  $120.00 Per Student per year

 

First student Information

• First and Last Name:
• DATE OF BIRTH?
• Grade:
• Church of Baptism:
• Check the Sacrament to Receive:
  Please select the sacrament(s) to celebrateBaptismReconciliationFirst CommunionConfirmation
• Student Need's Special Attention?
  YesNo
• Please Describe:

 

Second Student Information

• First and Last Name:
• DATE OF BIRTH?
• Grade:
• Church of Baptism:
• Check the Sacrament to Receive:
  Please select the sacrament(s) to celebrateBaptismEucharist / First CommunionConfirmation
• Student Need's Special Attention?
  YesNo
• Please Describe:

 

Third Student Information:

• First and Last Name:
• DATE OF BIRTH:
• Grade:
• Church of Baptism:
• Check the Sacrament to Receive:
  Please select the sacrament(s) to celebrateBaptismEucharist / First CommunionConfirmation
• Student Need's Special Attention?
  YesNo
• Please Descibe:

 

PLEASE CLICK SUBMIT

• This box is for spam protection - <strong>please leave it blank</strong>: