Parish Registration Form

Type of Registration

New Parishioner Registration

Current Parishioner Update

Family Surname

Date

Street Address

City

State

Zip

Name & Location of Previous Parish

May we share your personal information with our Parish Ministries?

Yes

No

Preferred Language

English

Spanish

Polish

Other

1st Head of Household - Marital Status

1st Head of Household - First Name

1st Head of Household - Last Name (+maiden name if appl)

1st Head of Household - Primary Phone Number

1st Head of Household - Additional Phone Number

1st Head of Household - Email Address

1st Head of Household - Date of Birth

1st Head of Household - Place of Birth

1st Head of Household - Sacraments Completed

Baptism

1st Communion

Confirmation

Marriage

1st Head of Household - Church of Baptism

City

State

Please note the Dates & Places of Sacraments Rec'd:

2nd Head of Household - Marital Status

2nd Head of Household - First Name

2nd Head of Household - Last Name (+maiden name if appl)

2nd Head of Household - Primary Phone Number

2nd Head of Household - Additional Phone Number

2nd Head of Household - Email Address

2nd Head of Household - Date of Birth

2nd Head of Household - Place of Birth

2nd Head of Household - Sacraments Completed

Baptism

First Communion

Confirmation

Marriage

2nd Head of Household - Church of Baptism

City

State

Please note the Dates & Places of Sacraments Rec'd:

3rd Household Member - First Name

3rd Household Member - Last Name

3rd Household Member - Date of Birth

3rd Household Member -Place of Birth

3rd Household Member - Sacraments Completed

Baptism

1st Communion

Confirmation

3rd Household Member - Church of Baptism

City

State

Please note the Dates & Places of Sacraments Rec'd:

4th Household Member - First Name

4th Household Member - Last Name

4th Household Member - Date of Birth

4th Household Member -Place of Birth

4th Household Member - Sacraments Completed

Baptism

1st Communion

Confirmation

4th Household Member - Church of Baptism

City

State

Please note the Dates & Places of Sacraments Rec'd:

5th Household Member - First Name

5th Household Member - Last Name

5th Household Member - Date of Birth

5th Household Member - Place of Birth

5th Household Member - Sacraments Completed

Baptism

1st Communion

Confirmation

5th Household Member - Church of Baptism

City

State

Please note the Dates & Places of Sacraments Rec'd:

I would like to learn more about:

If Other, please specify

Parish Registration Form

Parish Registration Form

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