Parish Registration Form
Please fill out this form to register at our parish.
Salutation for Mailing *
e.g. Mr. and Mrs. John Doe
Your answer
Telephone *
Your answer
Telephone Unlisted?
Household Email Address *
Your answer
Address 1 *
Your answer
Address 2
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Parish Directory *
What information would you like included in the Parish Directory?
Required
First Adult
Title *
e.g. Mr/Mrs/Ms/Dr
Your answer
First Name *
Your answer
Last Name *
Your answer
Work Phone Number/Email
Your answer
Date of Birth *
MM/DD/YYYY
Your answer
Religion *
e.g. Catholic
Your answer
Occupation *
Your answer
Employer
Your answer
Sacraments Completed
What Sacraments have you completed?
Marital Status *
If married, was it by a Catholic priest or deacon?
Anniversary
If married or engaged, date of wedding? (MM/DD/YYYY)
Your answer
Wedding location
If married or engaged, location of wedding? (Church/Location)
Your answer
Second Adult
Title
e.g. Mr/Mrs/Ms/Dr
Your answer
First Name
Your answer
Last Name
Your answer
Work Phone Number/Email
Your answer
Date of Birth
MM/DD/YYYY
Your answer
Religion
e.g. Catholic
Your answer
Occupation
Your answer
Employer
Your answer
Sacraments Completed
What Sacraments have you completed?
Marital Status
If married, was it by a Catholic priest or deacon?
Anniversary
If married or engaged, date of wedding? (MM/DD/YYYY)
Your answer
Wedding location
If married or engaged, location of wedding? (Church/Location)
Your answer
Any other adults in residence?
Names and Relationship
Your answer
Children
Please list all children under 18 living at home; please give dates for sacraments.
Child 1 First Name
Your answer
Child 1 Last Name
Your answer
Child 1 Date of birth
Your answer
Child 1 School Name
Your answer
Child 1 Grade
Your answer
Child 1 Baptism Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 1 Communion Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 1 Confirmation Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 2 First Name
Your answer
Child 2 Last Name
Your answer
Child 2 Date of birth
Your answer
Child 2 School Name
Your answer
Child 2 Grade
Your answer
Child 2 Baptism Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 2 Communion Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 2 Confirmation Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 3 First Name
Your answer
Child 3 Last Name
Your answer
Child 3 Date of birth
Your answer
Child 3 School Name
Your answer
Child 3 Grade
Your answer
Child 3 Baptism Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 3 Communion Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 3 Confirmation Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 4 First Name
Your answer
Child 4 Last Name
Your answer
Child 4 Date of birth
Your answer
Child 4 School Name
Your answer
Child 4 Grade
Your answer
Child 4 Baptism Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 4 Confirmation Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 4 Communion Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 5 First Name
Your answer
Child 5 Last Name
Your answer
Child 5 Date of birth
Your answer
Child 5 School Name
Your answer
Child 5 Grade
Your answer
Child 5 Baptism Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 5 Communion Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Child 5 Confirmation Received?
Please fill in date (MM/DD/YYYY) that the sacrament was received otherwise, leave blank
Your answer
Other
Which Mass(es) do you normally attend?
Additional household information or any special needs?
Your answer
Please have a priest contact me regarding:
Your answer
Submit
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