Parish Registration Form
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Family Address
Primary Family Address
Our Family is
New
Currently Registered (Updating Information)
How long have you be attending the church?
Family Name
Envelope Number
For updates only
Address
Primary E-mail
Cell Phone
Preferred Mailing Name
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Head of Household
Name
Select title
Ms
Miss
Mrs
Mr
Dr
Date of Birth
Education / Degree
Occupation / Profession
Full time or Part time?
E-mail
Cell Phone
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Spouse
Name
Select title
Ms
Miss
Mrs
Mr
Dr
Maiden Name
Date of Birth
Education / Degree
Occupation / Profession
Full time or Part time?
E-mail
Cell Phone
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Marital Status
Marital Status
Married
Single
Widowed
Divorced
Separated
Were you sacramentally married in the Catholic Church?
Yes
No
N/A
Marriage Date
If not sacramentally married please indicate:
Non-Catholic Ceremony
Civil Ceremony
Church name & City/State
Location & City/State
May we provide information on
Sacramental Marriage
Annulment
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Children
Number of Children
0
1
2
3
4
Child 1
Name
Gender
Male
Female
Date of Birth
School / Grade / Degree
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Living at home?
Yes
No
Languages Spoken
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Child 2
Name
Gender
Male
Female
Date of Birth
School / Grade / Degree
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Living at home?
Yes
No
Languages Spoken
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Child 3
Name
Gender
Male
Female
Date of Birth
School / Grade / Degree
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Living at home?
Yes
No
Languages Spoken
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Child 4
Name
Gender
Male
Female
Date of Birth
School / Grade / Degree
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Living at home?
Yes
No
Languages Spoken
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
Would you like to add an additional family member?
Yes
No
Other Family Member
Relationship
Name
Gender
Male
Female
Date of Birth
School / Grade / Degree
Religion
Catholic
Baptist
Episcopal
Lutheran
Presbyterian
Methodist
Other
Ethnicity
White
African American
Hispanic
Filipino
Indian
Biracial
Other
Living at home?
Yes
No
Languages Spoken
Sacraments
Baptism
Reconciliation
Holy Eucharist
Confirmation
Matrimony
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Additional Questions
May we provide information regarding Baptism, Reconciliation, Holy Eucharist, and Confirmation for those in the family who have not yet received these sacraments?
Yes
No
Not now
Do you wish to be added to our envelope system?
Yes
No
Not now
Would you prefer to participate in On-Line Giving?
Yes
No
Not now
Do you know how you might like to volunteer at our Parish?
Ministries Family Members may be interested in:
Skills and Talents family members may be able to offer to the parish:
What brings you to Our Parish at this time?
Additional Information:
Total Amount
Verification
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