Parish Registration Form
Please fill out this form to start your registration at Saint Mary Queen of the Universe Catholic Church.
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Adult Male -- First name
Your answer
Adult Male -- Date of Birth
MM
/
DD
/
YYYY
Marital Status
Adult Male -- Religion
Your answer
Adult Female -- First name (and maiden name)
Your answer
Adult Female -- Date of Birth
MM
/
DD
/
YYYY
Marital Status
Adult Female -- Religion
Your answer
Phone numbers of adults in household (list name next to each number please) *
Your answer
Email Addresses of adults in household (list name next to each email address please)
Your answer
Name and date of birth of Children under age 18 (if baptized, please list location of church)
Your answer
Submit
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