Parish Registration

For Parish Registration, please complete the form below and return to the Parish Center or drop in the collection basket during Weekend Mass.

Download the Parish Registration or fill out the Online Fillable Form below:

Head of Household
Name of Head of Household*
Prefix First Middle Last Suffix
HOH Maiden & Nickname
Maiden Nickname
Date of Birth*
Born*
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone Number*
Cell Phone Number
Work Phone Number
Email Address*
Occupation*
Employer*
Employer will match gifts
- Yes
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Marital Status*
- Single
- Engaged
- Married
- Widowed
- Separated
- Divorced
Religion*
- Catholic
Permission to publish information in Parish Directory*
Check the box to indicate permission for the Parish to use that piece of information in the Parish Directory
- Address
- Phone
- Email
- None
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Date of Marriage*
Church and Place of Marriage*

Please include Church name and City,ST of that Church
Number of Dependent Children*
If none put 0
Contributions*
- Credit Card
- EFT
- Envelopes
Emergency Contact
Contact Name*
First Last
Contact's Phone Number*
Relationship to Contact*
Spouse Information
Name of Spouse*
Prefix First Middle Last Suffix
Spouse Maiden & Nickname
Maiden Nickname
Date of Birth*
Born*
Address (if different than above)
Street Address Address Line 2 City State ZIP Code
Home Phone Number*
Cell Phone Number
Work Phone Number
Email Address*
Occupation*
Employer*
Employer will match gifts
- Yes
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Religion*
- Catholic
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Dependent Child #1
Name of Child #1*
Prefix First Middle Last Suffix
Child #1 Maiden & Nickname
Maiden Nickname
Gender*
- Male
- Female
Date of Birth*
Born*
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Date of Marriage*
Church and Place of Marriage*

Please include Church name and City,ST of that Church
Dependent Child #2
Name of Child #2*
Prefix First Middle Last Suffix
Child #2 Maiden & Nickname
Maiden Nickname
Gender*
- Male
- Female
Date of Birth*
Born*
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Date of Marriage*
Church and Place of Marriage*

Please include Church name and City,ST of that Church
Dependent Child #3
Name of Child #3*
Prefix First Middle Last Suffix
Child #3 Maiden & Nickname
Maiden Nickname
Gender*
- Male
- Female
Date of Birth*
Born*
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Date of Marriage*
Church and Place of Marriage*

Please include Church name and City,ST of that Church
Dependent Child #4
Name of Child #4*
Prefix First Middle Last Suffix
Child #4 Maiden & Nickname
Maiden Nickname
Gender*
- Male
- Female
Date of Birth*
Born*
Education*
Please list education starting from elementary to highest education level completed and list school (One per line)
Sacramental History*
- Baptized
- First Communion
- Confirmation
- Marriage
- None
Church and Place of Baptism*

Please include Church name and City,ST of that Church
Church and Place of First Communion*

Please include Church name and City,ST of that Church
Church and Place of Confirmation*

Please include Church name and City,ST of that Church
Date of Marriage*
Church and Place of Marriage*

Please include Church name and City,ST of that Church
Additional Information
Any Additional Information or Comments?
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Name
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Parish Registration

Head of Household

Emergency Contact

Spouse Information

Dependent Child #1

Dependent Child #2

Dependent Child #3

Dependent Child #4

Additional Information