GodTeen Registration Form

All Saints Catholic Church

Please complete form for high school students.

Parent information

Father's Name

First Name

Last Name

Father's Phone

Mother's Name

First Name

Last Name

Mother's Phone

Parent E-mail

Family Address

Street 1*

Street 2

City*

State*

Zip*

Volunteer Opportunities

Please share your talents with us. Fill in any talents you have that you could share with our students. Examples include Service Projects, Transportation needs, Witness Statements

GodTeen fees

There is a $25 fee per student. ($10 All Saints program fee and $15 Diocese of Lincoln Education fee). Please add "GodTeen" to your memo line.

Confirmation Classes

I have a student that will be attending Confirmation classes this year.
Required*

Confirmation at All Saints on April 6, 2019*

	YES
	NO

Confirmation is for those in 5th & 6th grades or anyone older that has not received the Sacrament. Classes held monthly on a Sunday evening. students need to bring one parent or their sponsor to class.

1st Student information

Student's Name

First Name*

Middle Name

Last Name*

Birth Date

Required* //

Grade level in the fall
Required*

	9th grade
	10th grade
	11th grade
	12th grade

Please select one.

Student's Phone

Required* --

Text updates OK for teens
Required*

	yes
	no

please check yes or no

Student Email

Required*

2nd Student information

Student's Name

First Name

Middle Name

Last Name

Date of Birth

Grade level in the fall

	9th grade
	10th grade
	11th grade
	12th grade

Please select one.

Student's Phone

Text updates OK for teens

	yes
	no

please check yes or no

Student E-mail

3rd Student information

Student's Name

First Name

Middle Name

Last Name

Date of Birth

Grade level in the fall

	9th grade
	10th grade
	11th grade
	12h grade

Please select one.

Student's Phone

Text updates OK for teens

	yes
	no

please check yes or no

Student E-mail

GodTeen Fees

FeesRequired* The Registration fee and Diocesan Education fee is per student, for all students. The Confirmation book fee is for those in 5th/6th grades or any older student who has not yet received Confirmation.

		Quantity	Extended

	Registration fee \| $10.00
	Diocese of Lincoln Regligious Education Fee \| $15.00
	Confirmation Book fee \| $25.00
	Additional Donation \| $1.00

Order Summary

Subtotal
Discount
Sales Tax
Shipping & Handling
Total

Payment Type Invoice

Invoice How do you prefer to receive bills?
I prefer to receive bills by email.
I prefer to receive bills by postal mail.

Billing Contact Name
First Name*	Last Name*

Phone Required* -- Provide a contact phone number for the billing contact.

Billing Address

Street 1*

Street 2

City*

State*

Zip*

Provide the billing address

GodTeen Registration Form

All Saints Catholic Church

Registration fee | $10.00

Diocese of Lincoln Regligious Education Fee | $15.00

Confirmation Book fee | $25.00

Additional Donation | $1.00