New Parishioner Regsitration Form-website.xlsx
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St. Mary Parish, Appleton, WI
Envelope #:
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312 S. State Street, Appleton, WI 54911
office
Reg. Date:
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New Parishioner Family Registration Form
use
Taken by:
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Check-in Date:
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 Fin. Pledge  T&T pledge  XCS
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Thank you for your interest in St. Mary Parish. We are happy to welcome you into our family! We look forward
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to meeting you, learning more about you, and telling you about what St. Mary Parish has to offer you. Please
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take a moment to complete this form prior to your appointment to become a registered member. Thank you!
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PLEASE PRINT
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Family Name:
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Address:
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City/State:
Zip:
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Home Phone w/ area code:
Emergency Phone:
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Primary/Family E-mail:
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Previous Parish Name:
City/State:
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What attracted you to St. Mary Parish?
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Do you have children in:  St. Francis Xavier school system OR  Religious Education (IPRF)
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Adult Member Information
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Role / Relationship Head of Household*Spouse / Other:
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Last Name (if Different) *
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First Name/Middle Initial M.I.*M.I.
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Maiden Name*
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Nickname / Gender
Male / Female
*
Male / Female
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Date of Birth (mm/dd/yyyy)
*
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Personal E-mail*
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Cell Phone:*
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Work Phone:*
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Occupation*
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Employer*
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Sacramental InfoMM/DD/YYReligion*MM/DD/YYReligion
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Baptized Y / N*Y / N
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Location (Church/City)*
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First CommunionY / N*Y / N
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ConfirmedY / N*Y / N
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Location (Church/City)*
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MarriageY / N*Y / N
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Location (Church/City)*
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Status
Catholic wedding / Civil / Other:
*
Catholic wedding / Civil / Other:
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(circle all that apply)widowed / annulled / divorced / separated*widowed / annulled / divorced / separated
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Please register additional family members on the back of this form. updated 10-2016
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Member #1Member #2
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Relationshipson, daughter, step child, mother, father, other*son, daughter, step child, mother, father, other
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to Head of Household:
*
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Last Name (if different)*
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First Name / Middle initial
M.I.*M.I.
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Nickname / Gender
Male / Female
*Male / Female
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Date of Birth (mm/dd/yyyy)
*
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School Name*
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Grade/Year in School*
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E-mail (if 18 yrs or older)*
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Sacramental InfoMM/DD/YYReligion*MM/DD/YYReligion
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Baptized Y / N*Y / N
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Location (Church/City)*
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First CommunionY / N*Y / N
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ConfirmedY / N*Y / N
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Location (Church/City)*
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Member #3Member #4
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Relationshipson, daughter, step child, mother, father, other*son, daughter, step child, mother, father, other
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to Head of Household:
*
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Last Name (if different)*
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First Name / Middle initial
M.I.*M.I.
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Nickname / Gender
Male / Female
*Male / Female
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Date of Birth (mm/dd/yyyy)
*
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School Name*
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Grade/Year in School*
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E-mail (if 18 yrs or older)*
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Sacramental InfoMM/DD/YYReligion*MM/DD/YYReligion
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Baptized Y / N*Y / N
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Location (Church/City)*
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First CommunionY / N*Y / N
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ConfirmedY / N*Y / N
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Location (Church/City)*
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COMMENTS:
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