Parish Registration

Please fill out this registration form and click submit.

Today's Date

*

Are you Catholic

*

Please select one option.

Yes No

Family Information

Family Last Name

*

Address

*

Home Phone

Mobile Phone

Marital Status

Please select one option.

Single Married Divorced Widowed

Catholic Marriage?

Please select one option.

Yes No

Date of Marriage

Check any that you are interested in:

Please select all that apply.

Please have the Welcoming Committee contact me Please send starter envelopes I'm interested in E-Giving (not paper envelopes) Please mail me a welcome packet

Male Family Member Information

Male: First, Middle, Last

Male: Date of Birth

Male: Email

This address will receive a confirmation email

Male: Occupation

Male: Sacramental information (check if sacrament completed)

Please select all that apply.

Baptized 1st Communion Confirmation

Female Family Member Information

Female: First, Middle, Last

Female: Date of Birth

Female: E-Mail

Female: Occupation

Female: Sacramental Information (check if sacrament completed)

Please select all that apply.

Baptized 1st Communion Confirmed

Child 18 and under living with you

Child: Gender

Please select one option.

Male Female

Child: First, Middle, Last

Child: Date of Birth

Child: Sacramental Information

Please select all that apply.

Baptized 1st Communion Confirmed

Child 18 and under living with you

Child: Gender

Please select one option.

Male Female

Child: First, Middle, Last

Child: Date of Birth

Child: Sacramental Information

Please select all that apply.

Baptized 1st Communion Confirmed

Child 18 and under living with you

Child: Gender

Please select one option.

Male Female

Child: First, Middle, Last

Child: Date of Birth

Child: Sacramental Information

Please select all that apply.

Baptized 1st Communion Confirmed

Description

Please fill out this registration form and click submit.

Please Fix the Following

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