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
Adult Male -- First name
Your answer
Adult Female -- First name (and maiden name)
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone numbers for adults in household *
Untitled Title
Email Address
Your answer
Adult Male -- Date of Birth
MM
/
DD
/
YYYY
Adult Male -- Religion
Your answer
Adult Female -- Date of Birth
MM
/
DD
/
YYYY
Adult Female -- Religion
Your answer
Name and date of birth of Children under age 18 (if baptized, please list location of church)
Your answer
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