St. Francis Xavier Church - Time and Talent Commitment 2025
Please list all your family members and provide up-to-date information for each one. Be sure to list ALL members of your household (Children up to age 24 if they are living with you), even if one of them cannot serve currently at this time. Children aged 24 and older are considered separate members of the parish and should complete their own form. 
All parish volunteers must complete the Safe Environment requirements of the diocese. This includes completion of the VIRTUS class, and a background check for those working directly with children. If you have any questions or concerns about this, please contact Deacon Mike Berendzen at 573-694-4916.
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Email *
Family Name  *
Full Address *
Phone Number *
Family E-mail: *
I would like for the parish office to contact me about starting or changing my financial giving. *
Required
Family Member #1 Name *
Family Member #1 Alternative Phone #
Family Member #1 Date of Birth *
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Pillar of Hospitality
Please place a check mark next to the ministry in which family member #1 would like to serve.
Pillar of Prayer
Please place a check mark next to the ministry in which family member #1 would like to serve.
Mass Preference
Which Mass time preference does family member # 1 prefer? Check all that apply.
Pillar of Formation
Please place a check mark next to the ministry in which family member #1 would like to serve.
Pillar of Service
Please place a check mark next to the ministry in which family member #1 would like to serve.
Family Member #2 Name
Family Member #2 Alternative Phone #
Family Member #2 Date of Birth
MM
/
DD
/
YYYY
Pillar of Hospitality
Please place a check mark next to the ministry in which family member #2 would like to serve.
Pillar of Prayer
Please place a check mark next to the ministry in which family member #2 would like to serve.
Mass Preference
Which Mass time preference does family member # 2 prefer? Check all that apply.
Pillar of Formation
Please place a check mark next to the ministry in which family member #2 would like to serve.
Pillar of Service
Please place a check mark next to the ministry in which family member #2 would like to serve.
Family Member #3 Name
Family Member #3 Alternative Phone #
Family Member #3 Date of Birth
MM
/
DD
/
YYYY
Pillar of Hospitality
Please place a check mark next to the ministry in which family member #3 would like to serve.
Pillar of Prayer
Please place a check mark next to the ministry in which family member #3 would like to serve.
Mass Preference
Which Mass time preference does family member # 3 prefer? Check all that apply.
Pillar of Formation
Please place a check mark next to the ministry in which family member #3 would like to serve.
Pillar of Service
Please place a check mark next to the ministry in which family member #3 would like to serve.
Family Member #4 Name
Family Member #4 Alternative Phone #
Family Member #4 Date of Birth
MM
/
DD
/
YYYY
Pillar of Hospitality
Please place a check mark next to the ministry in which family member #4 would like to serve.
Pillar of Prayer
Please place a check mark next to the ministry in which family member #4 would like to serve.
Mass Preference
Which Mass time preference does family member # 4 prefer? Check all that apply.
Pillar of Formation
Please place a check mark next to the ministry in which family member #4 would like to serve.
Pillar of Service
Please place a check mark next to the ministry in which family member #4 would like to serve.
I am unsure where to serve. Please contact me.
A copy of your responses will be emailed to the address you provided.
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