Facebook Instagram Email

Returning Student RCIC

These children attended classes this past year 2024-2025 and are Not Baptized
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Student Information
  
  Student Name / Nombre REQUIRED Please fill out this field. Please enter valid data.
  
  Student Last Name / Apellido REQUIRED Please fill out this field. Please enter valid data.
  
  Student Grade Level / Grado en la Escuela (2025-2026) REQUIRED Please fill out this field.
  
  Mother's Information
  
  Mother's Name / Nombre de Madre Please enter valid data.
  
  Mother's Phone Number / # de Telefono de Madre Maximum 20 characters Please enter a phone number.
  
  Mother's Email / Correo Electronico Please enter an email address.
  
  Mother's Preferred Language / Idioma de la Madre
  
  Father's Information
  
  Father's Name / Nombre del Padre Please enter valid data.
  
  Father's Phone Number / # de Telefono del Padre Maximum 20 characters Please enter a phone number.
  
  Father's Email / Correo Electronico Please enter an email address.
  
  Father's Preferred Language / Idioma del Padre
  
  Emergency Information
  
  Emergency Contact's Name (Other than Parent) / Contacto de Emergencia REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact's Phone Number / Numero de Emergencia REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Emergency Contact's Relationship to Student / Relacion con el estudiante REQUIRED Please fill out this field. Please enter valid data.
  
  Any medical conditions we should be aware of (allergies, learning or physical disabilities, etc.) / Favor de indicar problemas medicos o dificultades de aprendizaje (Incluyendo alergias) Please enter valid data.
  
  Please provide preferred cell # to receive notifications through our flock note system: / Por favor de proveer el # celular para recibir notificaciones: Maximum 20 characters Please enter a phone number.
  
  Please provide preferred email to receive notifications through our flock note system: / Por favor provee el correo electronico donde quiera recibir notificaciones: Please enter an email address.
  
  Change of Address? / ?Tiene cambio de domicilio?
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.