Parish Registration

This first section of the registration form concentrates on the Head of Household and primary information.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Family Primary Email Address (our main form of Communication) Please enter valid data.

Cell Phone Number Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Are the disabilities we should be aware of? Please enter valid data.

Birth date (ex. 1/23/1982) REQUIRED Please fill out this field. Please enter valid data.

Role REQUIRED Please fill out this field.

Sex Male Female

Marital Status

Occupation Please enter valid data.

Family Mailing Address REQUIRED Please fill out this field.

Do we have permission to publish your address, phone # and email address in a parish directory? No - Address No - Phone # No - Email Address

Method of Contribution EFT Debit

Sacraments Received (Check the appropriate boxes) Baptism First Reconciliation First Communion Confirmation Marriage

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Spouse's Religion Please enter valid data.

If not Catholic - would you like information on OCIA (steps to join the church)? REQUIRED Please fill out this field. Please enter valid data.

Spouse's Disabilities (if applicable) Please enter valid data.

Spouse's Cell Phone Please enter valid data.

Spouse 's Email address (if other than primary household email) Please enter valid data.

Spouse's Birth Date (ex. 1/23/1982) Please enter valid data.

Role

Spouse's Sex (M or F) Please enter valid data.

Marital Status

Spouse's Occupation Please enter valid data.

Spouse - Sacraments Received (Check the appropriate boxes) Baptism First Reconciliation First Communion Confirmation Marriage