SAINT JEROME SCHOOL
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250 Wall Street
West Long Branch, NJ
732-222-8686

 
 
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Registration Form

Registration Form Instructions:

All information given is STRICTLY CONFIDENTIAL.

  1. FAMILY MEMBERS
    This is information about each person living at the Household address. If there is more than one family name (children from a previous marriage, in-laws living with you, etc.) list those Last Names with the First Name in the appropriate space.
     
  2. SACRAMENTAL INFORMATION
    Where requested, specific dates are helpful. If you cannot find these dates, use approximate dates, giving at least the year and month if known such as 11/28/66, or 11/66 (if the day is unknown), or just 1966 (if only the year is known).  If you don’t know the year, please put YES or NO to having received the sacrament.
     
  3. ADDITIONAL INFORMATION
    If you have any additional information you feel is pertinent that is not shown on the form, please just make notes in the Other Information section.  If you have any questions about the form, please call the Rectory at 732-222-1424 Monday – Friday from 9:00am – 4:00pm and speak to our Parish Secretary.

Registration Form

  
Family Last Name
Mailing Label Name
(e.g., Mr & Mrs. Joe Doe, John & Mary Doe, etc.)
Street Address
City
State
Zip
Primary Phone
Cell Phone
Family Email
Special Circumstances
Family Member 1
First Name
Maiden Name
or last name if different
from family name
Family Relationship
Sex Male
Female
Birth Date
Marital Status
Date of Marriage
Marriage Recognized by Catholic Church Yes
No
Religion
Baptism
First Communion
Confirmation