Church Registration Form
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Please DO NOT use this form to notify us of updates to your original registration information; call the church office.
Enter dates as:  mm-dd-yyyy.  Enter phone numbers as:  999-999-9999.  Thank you.

Required information is marked with a red asterisk.

FAMILY INFORMATION

Family Last Name:*
Residence Address:*
City*
State:*
Zip Code:*

Mailing Address.  If same as Residence Address, skip to Home Phone

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Mailing Address:
City:
State
Zip Code

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Home Phone:*
Work Phone:
Cell Phone
Marital Status

HEAD OF HOUSEHOLD INFORMATION

First & Last Name*
Gender
Religion*
Country of Birth*
Date of Birth (mm-dd-yyyy)*
Sacraments Received
Occupation

SPOUSE OR SIGNIFICANT OTHER INFORMATION

First & Last Name:
Religion:
Country of Birth:
Date of Birth (mm-dd-yyyy):
Sacraments Received:
Occupation:

CHILDREN AND OTHER ADULTS LIVING AT THIS ADDRESS
(add adult names only if they will not register separately)

1. First & Last Name
1. Gender
1. Religion
1. Country of Birth
1. Date of Birth
1. Sacraments Received

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2. First & Last Name
2. Gender
2. Religion
2. Country of Birth
2. Date of Birth
2. Sacraments Received

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3. First & Last Name
3. Gender
3. Religion
3. Country of Birth
3. Date of Birth
3. Sacraments Received

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4. First & Last Name
4. Gender
4. Religion
4. Country of Birth
4. Date of Birth
4. Sacraments Received

ADDITIONAL INFORMATION

1. For donation tracking, do you want to received offertory envelopes?
2. Spouse's Maiden Name (Important, if applicable)

3.  In order for us to help serve you and reduce the expenses incurred sending letters and postcards to our parish family, your email address is requested.  Please call us when this address changes or is eliminated.  Thank you.

My preferred correspondence method is:
Email Address

Enter "none" if you do not have or do not want to use an email address.

If you need to submit another form to add more children and/or adults:  
1.  Submit this page first.
2.  On the acknowledgement page, return to the form
3.  In the Residence Address space on the new blank form, type "PAGE 2" (or "PAGE 3," etc).
4.  Fill in all the required fields again.
5.  In the "Children and Other Adults Living at this Address" section, continue to add names and information.
6.  Submit form.

Before you submit this form, we would like to know if there are any church ministries you would be interested in.  If so, please
enter your interests below...

Areas of Interest
Please verify the phrase below:

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