St. John the Evangelist Parish

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REGISTRATION FORM

Family Name *

Mr.

Mrs.

Mr. & Mrs.

Miss/Ms.

Other:

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Marital Status *

Never Married

Married

Divorced/Separated

Widowed

Male (first name) *

If no male, please enter "none"

Date of Birth *

Male's Religion

Catholic

Other Christian

Other non-Christian

None

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Female (first name) *

If no female, please enter "none"

Maiden *

Date of Birth *

Female's Religion

Catholic

Other Christian

Other non-Christian

None

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Address *

City *

Zip *

His phone (please indicate home or cell phone)

Her phone (please indicate home or cell phone)

Primary Phone *

Primary email address *

Would you like to be added to our email update list?

Yes

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Would you like your contributions applied to St. John or St. Joseph *

St. John the Evangelist

St. Joseph Oratory

Male: Church of Baptism *

Name of church, city, state. Only enter "none" if never Baptized in any Christian faith

Sacraments (Male)

Please select if "YES"

Yes

Married by priest/deacon

First Reconciliation

Attends Mass

Confirmed

First Communion

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Female: Church of Baptism *

Name of church, city, state. Only enter "none" if never Baptized in any Christian faith

Sacraments (Female)

Please select if "YES"

Yes

Married by priest/deacon

First Reconciliation

Attends Mass

First Communion

Confirmed

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Children

Dependents in the household, under the age of 26

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This form was created inside of St. John the Evangelist Parish.