Parish Registration

This first section of the registration form concentrates on the Head of Household and primary information.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Family Primary Email Address (our main form of Communication) Please enter valid data.

Cell Phone Number Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Are the disabilities we should be aware of? Please enter valid data.

Birth date (ex. 1/23/1982) REQUIRED Please fill out this field. Please enter valid data.

Sex Male Female

Occupation Please enter valid data.

Family Mailing Address REQUIRED Please fill out this field.

Do we have permission to publish your phone # in a parish directory? Yes No

Method of Contribution EFT Debit

Sacraments Received (Check the appropriate boxes) Baptism First Communion Confirmation Marriage

This next section of the parish registration form concentrates on the spouse (if applicable).

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Spouse's Religion Please enter valid data.

If not Catholic - would you like information on RCIA (steps to join the church)? REQUIRED Please fill out this field. Please enter valid data.

Spouse's Disabilities (if applicable) Please enter valid data.

Spouse's Cell Phone Please enter valid data.

Spouse 's Email address (if other than primary household email) Please enter valid data.

Spouse's Birth Date (ex. 1/23/1982) Please enter valid data.

Spouse's Sex (M or F) Please enter valid data.

Spouse's Occupation Please enter valid data.

Spouse - Sacraments Received (Check the appropriate boxes) Baptism First Reconciliation First Communion Confirmation Marriage