Parish Registration

Thanks for taking a moment to register your household's information with our parish's office. Please fill out the form as completely as possible and then click submit.

Family Information
Last Name
  •  
Family E-mail
  •  
Home Phone --
  •  
Envelope Number
  •  
Mailing Name
  •  
Emergency Phone --
  •  
Address
  •  
Option
  •  
Member 1 Information
Status at Parish
  •  
Name
  •  
Nickname
  •  
Role
  •  
Date of Birth //
  •  
Gender
  •  
Maiden Name
  •  
E-mail
  •  
Ethnicity
  •  
Birth Place
  •  
First Language
  •  
Phone Number --
  •  
Special Needs
  •  
High School Graduation Year
  •  
Member 1 Sacramental Information
Catholic
  •  
If No, Please Specify Religion
  •  
Baptism Date  
  •  
Baptism Location
  •  
Reconciliation Date  
  •  
Reconciliation Prep Location
  •  
First Eucharist Date  
  •  
First Eucharist Location
  •  
Confirmation Date  
  •  
Confirmation Location
  •  
Catholic Marriage Date  
  •  
Catholic Marriage Location
  •  
Member 2 Information
Status at Parish
  •  
Name
  •  
Nickname
  •  
Role
  •  
Gender
  •  
Date of Birth //
  •  
Maiden Name
  •  
E-mail
  •  
Birthplace
  •  
Ethnicity
  •  
Phone Number --
  •  
First Language
  •  
Special Needs
  •  
High School Graduation Year
  •  
Member 2 Sacramental Information
Catholic
  •  
If No, Please Specify Religion
  •  
Baptism Date  
  •  
Baptism Location
  •  
Reconciliation Prep Date  
  •  
Reconciliation Prep Location
  •  
First Eucharist Date  
  •  
First Eucharist Location
  •  
Confirmation Date  
  •  
Confirmation Location
  •  
Catholic Marriage Date  
  •  
Catholic Marriage Location
  •  
Member 3 Information
Name
  •  
Nickname
  •  
Status at Parish
  •  
Role
  •  
Gender
  •  
Date of Birth //
  •  
Maiden Name
  •  
E-mail
  •  
Birthplace
  •  
Ethnicity
  •  
Phone --
  •  
First Language
  •  
Special Needs
  •  
High School Graduation Year
  •  
Member 3 Sacramental Information
Catholic
  •  
If No, Please Specify Religion
  •  
Baptism Date  
  •  
Baptism Location
  •  
Reconciliation Prep Date  
  •  
Reconciliation Prep Location
  •  
First Eucharist Date  
  •  
First Eucharist Location
  •  
Confirmation Date  
  •  
Confirmation Location
  •  
Catholic Marriage Date  
  •  
Catholic Marriage Location
  •  
Member 4 Information
Status at Parish
  •  
Name
  •  
Nickname
  •  
Role
  •  
Gender
  •  
Date of Birth //
  •  
Maiden Name
  •  
E-mail
  •  
Birthplace
  •  
Ethnicity
  •  
Phone --
  •  
First Language
  •  
Special Needs
  •  
High School Grad Year
  •  
Member 4 Sacramental Information
Catholic
  •  
If No, Please Specify Religion
  •  
Baptism Date  
  •  
Baptism Location
  •  
Reconciliation Prep Date  
  •  
Reconciliation Prep Location
  •  
First Eucharist Date  
  •  
First Eucharist Location
  •  
Confirmation Date  
  •  
Confirmation Location
  •  
Catholic Marriage Date  
  •  
Catholic Marriage Location
  •  
Member 5 Information
Status at Parish
  •  
Name
  •  
Nickname
  •  
Role
  •  
Gender
  •  
Date of Birth //
  •  
Maiden Name
  •  
E-mail
  •  
Birthplace
  •  
Ethnicity
  •  
Phone --
  •  
First Language
  •  
Special Needs
  •  
High School Grad Year
  •  
Member 5 Sacramental Information
Catholic
  •  
If No, Please Specify Religion
  •  
Baptism Date  
  •  
Baptism Location
  •  
Reconciliation Prep Date  
  •  
Reconciliation Prep Location
  •  
First Eucharist Date  
  •  
First Eucharist Location
  •  
Confirmation Date  
  •  
Confirmation Location
  •  
Catholic Marriage Date  
  •  
Catholic Marriage Location
  •  
 
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