STPCICP Parishioner Form for Offline Mass Preparation (Pre-Registration Form)
This is NOT a booking form for Offline/Physical Mass.
After you submit this form, if you are eligible to attend the mass, you will receive an EMAIL on Sunday Evening that will guide you to sign up for the following Offline Sunday Mass (esp. for parishioners 12 - 59 years old) or Senior Mass (esp. for parishioners 60 years old & above). Please check your email regularly.
Starting November 2021 our parish offers regular SUNDAY MASS and scheduled SENIOR MASS.
For health & safety reasons, the Archdiocese of Jakarta allows only 20% of the regular Church capacity for the NEW NORMAL.
Please fill in the form carefully and submit one form for each individual in the family. All information will be treated with respect and kept confidential. THANK YOU & GOD BLESS US ALL.
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Email *
Full Name (based on I.D.) *
Nickname:
Date of Birth: *
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Place of birth; city, country
Nationality : *
I.D. - 1. Country of Passport *
Please state the country that issued your passport
I.D. - 2. Passport Number *
I.D. - 3. Passport Expiry Date *
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DD
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Active Mobile Phone Number: *
Current Residing Address: (Please provide your complete/detail home address incl. street, number, area (kelurahan). Incomplete address will not be processed) *
Current home address postal code (for example: St. Theresia Church is 10350) *
Select where your residential area located: *
ATTENTION: Once you submit this form, the information will be used to evaluate your eligibility to attend the physical Mass. IF you are invited, are you ready to come to the physical Mass? Your answer will be used to follow up with you in the future. *
Required
Would you like to receive news, update or information from St, Peter Canisius International Catholic Parish Jakarta? *
Required
You are : *
Have you been vaccinated? *
Required
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