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St. Pius X Parish Registration
Parish Registration or Update of St. Pius X Family Information
FAMILY LAST NAME: *
Your answer
CURRENT STREET ADDRESS: *
Your answer
CITY / STATE / ZIP CODE: *
Your answer
HEAD OF HOUSEHOLD INFORMATION
FULL NAME OF HEAD OF HOUSEHOLD: *
FIRST NAME / MIDDLE NAME / LAST NAME / SUFFIX
Your answer
OCCUPATION: *
Your answer
EMPLOYER: *
Your answer
HOME PHONE:
Your answer
CELL PHONE: *
Your answer
WORK PHONE:
Your answer
PRIMARY EMAIL ADDRESS: *
Your answer
SECONDARY EMAIL ADDRESS:
Your answer
HEAD OF HOUSEHOLD DATE OF BIRTH: *
MM
/
DD
/
YYYY
DATE OF MARRIAGE: *
If not married, please indicate status (Single, Divorced, Widow, etc.)
Your answer
Head of Household Religion *
Your answer
SPOUSE INFORMATION
FULL NAME OF SPOUSE (include middle & maiden name): *
If not married, please indicate Single, Divorced, Widow, etc.
Your answer
OCCUPATION: *
Your answer
EMPLOYER: *
Your answer
HOME PHONE:
Your answer
CELL PHONE: *
Your answer
WORK PHONE:
Your answer
SPOUSE PRIMARY EMAIL ADDRESS: *
Your answer
SPOUSE SECONDARY EMAIL ADDRESS:
Your answer
SPOUSE DATE OF BIRTH: *
MM
/
DD
/
YYYY
DATE OF MARRIAGE:
MM
/
DD
/
YYYY
Spouse Religion *
Your answer
CHILDREN LIVING IN YOUR HOUSEHOLD
LIST ALL CHILDREN AGES NEWBORN TO 21 YEARS OLD LIVING IN YOUR HOUSEHOLD
FIRST CHILD
1st CHILD'S FULL NAME:
FIRST NAME / MIDDLE NAME / LAST NAME / SUFFIX
Your answer
1st CHILD'S DATE OF BIRTH:
MONTH / DAY / YEAR
MM
/
DD
/
YYYY
1st CHILD'S DATE OF BAPTISM:
MONTH / DAY / YEAR
Your answer
1st CHILD'S CHURCH OF BAPTISM:
Your answer
1st CHILD'S CITY / STATE OF BAPTISM:
i.e., NEW ORLEANS LA
Your answer
SECOND CHILD
2nd CHILD'S FULL NAME:
FIRST NAME / MIDDLE NAME / LAST NAME / SUFFIX
Your answer
2nd CHILD'S DATE OF BIRTH:
MONTH / DAY / YEAR
MM
/
DD
/
YYYY
2nd CHILD'S DATE OF BAPTISM:
MONTH / DAY / YEAR
Your answer
2nd CHILD'S CHURCH OF BAPTISM:
Your answer
2nd CHILD'S CITY / STATE OF BAPTISM:
i.e., NEW ORLEANS LA
Your answer
THIRD CHILD
3rd CHILD'S FULL NAME:
FIRST NAME / MIDDLE NAME / LAST NAME / SUFFIX
Your answer
3rd CHILD'S DATE OF BIRTH:
MONTH / DAY / YEAR
MM
/
DD
/
YYYY
3rd CHILD'S DATE OF BAPTISM:
MONTH / DAY / YEAR
Your answer
3rd CHILD'S CHURCH OF BAPTISM:
Your answer
3rd CHILD'S CITY / STATE OF BAPTISM:
i.e., NEW ORLEANS LA
Your answer
FOURTH CHILD
4th CHILD'S FULL NAME:
FIRST NAME / MIDDLE NAME / LAST NAME / SUFFIX
Your answer
4th CHILD'S DATE OF BIRTH:
MONTH / DAY / YEAR
MM
/
DD
/
YYYY
4th CHILD'S DATE OF BAPTISM:
MONTH / DAY / YEAR
Your answer
4th CHILD'S CHURCH OF BAPTISM:
Your answer
4th CHILD'S CITY / STATE OF BAPTISM:
i.e., NEW ORLEANS LA
Your answer
Please check here if you have more than 4 children living in this household.
Please mail monthly envelopes to my home. *
Required
PARISH DIRECTORY
Please list my family in the next issue of the Parish Directory. *
Required
Please select below the information you agree to have printed in the parish directory: *
Required
How did you find out about St. Pius X Parish? *
(i.e. attended St. Pius X School, former parishioner, social media, etc.)
Your answer
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