Nativity School
1250 Laurel Street Menlo Park, CA 94025
www.nativityschool.com Phone (650)325-7304 Fax (650)325-3841

Annual Parishioner Certification Form

Name of Parent/Guardian:  

Address:

 

Student(s) Grade:
  Grade:
  Grade:

-------------------(To be completed and signed by Pastor or designate)-----------------

This family is known by me to meet parish criteria as active parishioners.

Registered in Parish
Yes
No
Involved in Parish
Yes
No
Contributes to Parish
Yes
No

Comments:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

___________________________________________________________________
Pastor (or designate) signature

___________________________________________________________________
Parish

___________________________________________________________________
Date

___________________________________________________________________
City

Please print out and send this letter directly to:
Nativity School
1250 Laurel Street
Menlo Park, CA 94025