Side Column 1
Parishioner Registration Form

Please be sure that you have filled out all applicable fields, including all Sacraments received..
  • Head of House
    Please fill out as completely as possible
    • Last Name*
       
    • First and Middle Name*
       
    • Maiden Name
        If applicable
    • Address*
       
    • Apt. #
       
    • City*
       
    • State*
       
    • Zip Code*
       
    • Sub Division
       
    • Home Phone*
       
    • Family E-mail*
       
      The parish office will use this to communicate with you
    • Head of House cell phone
       
    • Head of House work phone
       
    • Head of House 2nd Email
       
      Complete only if different from Family Email
    • Religion*
       
    • Gender
      Male
      Female
    • Date of Birth*
       (MM/DD/YYYY)  
    • Marriage Date
       (MM/DD/YYYY)  
    • Marital Status
       
    • Language
       
      First Language
    • Language
       
      Second Language
    • Baptism
      yes
      no
    • First Holy Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    • Ethnicity
       
    • Occupation
       
    •  
  • Spouse
    Please fill out as completely as possible.
    • Last Name
       
      Only if different from above
    • First and Middle Name
       
    • Maiden Name
        If applicable
    • Spouse's cell phone
       
    • Spouse's work phone
       
    • Spouse's Email
       
      Complete only if different from main Family email
    • Religion
       
    • Gender
      Male
      Female
    • Date of Birth
       (MM/DD/YYYY)  
    • Language
       
      First Language
    • Language
       
      Second Language
    • Baptism
      yes
      no
    • First Holy Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    • Ethnicity
       
    • Occupation
       
    •  
  • Child 1
    PLEASE INCLUDE THE SACRAMENTS YOUR CHILD HAS RECEIVED.
    • First and Middle Name
       
      Include last name if different from Head of House
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Child 2
    Please include Sacraments your child has received.
    • First and Middle Name
       
      Include Last Name if different from Head of House
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Child 3
    Please include all Sacraments your child has received.
    • First and Middle Name
       
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Child 4
    Please include all Sacraments your child has received.
    • First and Middle Name
       
      Include Last Name if different from Head of House
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Child 5
    Please include all Sacraments your child has received.
    • First and Middle Name
       
      Include Last Name if different from Head of House
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Child 6
    Please include the Sacraments your child has received.
    • First and Middle Name
       
      Include if different from Head of House
    • Religion
       
    • Gender
      Male
      Female
    • Grade
       
    • School
       
    • Date of Birth
       (MM/DD/YYYY)  
    • Baptism
      yes
      no
    • First Communion
      yes
      no
    • First Reconciliation
      yes
      no
    • Confirmation
      yes
      no
    •  
  • Security Code*

    (Enter the code above)
  •