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St. Mother Guerin Parishioner Registration Form
Confidential: This is for office use only. Please fill out as accurately as possible. Other adults, such as grandparents or working adult children, please register separately.
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* Indicates required question
Registration Date
*
Your answer
Parishioner Number (Office will fill in)
Your answer
Family Name
*
Your answer
Street Address
*
Your answer
City, State, Zip Code
*
Your answer
Phone
Your answer
Email
Your answer
Preferred contact method
Phone call
Text
Email
Other:
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Your Preferred Title
Mr.
Mrs.
Ms.
Miss
Other:
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Your last name
*
Your answer
Your maiden name (if applicable)
Your answer
Your first name
*
Your answer
Who's filling this out (Self, spouse)?
Your answer
Your birthdate
Your answer
Your Gender
Male
Female
Clear selection
Your Marital Status
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Single
Married
Widowed
Divorced
Separated
Your Religious Denomination
Your answer
Were you baptized?
Choose
Yes
No
Your Baptismal Date
Your answer
Church where you were baptized and location
Your answer
Did you receive your First Communion?
Yes
No
When did you receive your First Communion?
Your answer
What church did you receive your First Communion at (name and location)?
Your answer
Were you confirmed?
Yes
No
When were you confirmed?
Your answer
Where were you confirmed (church and location)?
Your answer
Did you get married in the Catholic Church?
Yes
No
Church and location of your marriage
Your answer
Date of your marriage
Your answer
Your occupation/school
Your answer
Your grade/degree completed
Your answer
Your ethnicity
Your answer
Languages you speak
Your answer
Member # 2 Preferred Title
Mr.
Mrs.
Ms.
Miss
Other:
Clear selection
Member #2 Last name
Your answer
Member #2 Maiden Name
Your answer
Member #2 First Name
Your answer
Member #2 Phone
Your answer
Member #2 Email
Your answer
Member #2 Birthdate
MM
/
DD
/
YYYY
Member #2 Gender
Male
Female
Clear selection
Member #2 Religious Denomination
Your answer
Member #2 Baptism
Yes
No
Member # 2 Baptismal Date
MM
/
DD
/
YYYY
Baptismal church name and location
Your answer
Member #2 First Communion
Yes
No
First Communion Date
Your answer
First Communion Church and Location
Your answer
Were you confirmed?
Yes
No
Other:
Member #2 Confirmation date
Yes
No
Clear selection
Church name and location where confirmed
Your answer
Member #2 Marital Status
Choose
Single
Married
Widowed
Divorced
Separated
Was Member #2 married in the Catholic Church?
Yes
No
Church name and location
Your answer
Member #2 Wedding Date
Your answer
Occupation/School
Your answer
Grade/Degree Completed
Your answer
Ethnicity
Your answer
Languages Spoken
Your answer
Member # 3 Preferred Title
Mr.
Mrs.
Ms.
Miss
Other:
Clear selection
Member #3 Last name
Your answer
Member #3 Maiden Name
Your answer
Member #3 First Name
Your answer
Member #3 Birth date
MM
/
DD
/
YYYY
Member #3 Gender
Male
Female
Clear selection
Member #3 Marital Status
Choose
Single
Married
Widowed
Divorced
Separated
Member #3 Religious Denomination
Your answer
Member #3 Baptism
Yes
No
Member # 3 Baptismal Date
MM
/
DD
/
YYYY
Church name and location
Your answer
Member #3 First Communion
Yes
No
Member #3 First Communion date
Your answer
Member #3 First Communion church and location
Your answer
Member #3 Confirmation
Yes
No
Clear selection
Confirmation church and location
Your answer
Confirmation date
Your answer
Member #3 Married in the Catholic Church?
Yes
No
Clear selection
Church name and location?
Yes
No
Clear selection
Wedding date
Yes
No
Clear selection
Occupation/School
Your answer
Grade/Degree Completed
Your answer
Ethnicity
Your answer
Languages Spoken
Your answer
Member # 4 Preferred Title
Mr.
Mrs.
Ms.
Miss
Other:
Clear selection
Member #4 Last name
Your answer
Member #4 Maiden Name
Your answer
Member #4 First Name
Your answer
Member #4 Birth date
MM
/
DD
/
YYYY
Member #4 Gender
Male
Female
Clear selection
Member #4 Phone
Your answer
Member #4 Email
Your answer
Member #4 Religious Denomination
Your answer
Member #4 Baptism
Yes
No
Member #4 Baptismal Date
MM
/
DD
/
YYYY
Church name and location?
Yes
No
Clear selection
Member #4 First Communion
Yes
No
Date of First Communion?
Your answer
Church name and location?
Your answer
Member #4 Confirmation
Yes
No
Clear selection
Date of Confirmation
Your answer
Church and location of Confirmation
Your answer
Member #4 Marital Status
Choose
Single
Married
Widowed
Divorced
Separated
Member #4 Married in the Catholic Church?
Yes
No
Clear selection
Church and location of marriage
Your answer
Wedding date
Your answer
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