Parish Registration Form

Please fill in all blanks that are applicable. Entries that have an asterisk (*) must be filled in; otherwise submittal will NOT be accepted.

Family LAST Name *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Tithing/Offering Envelopes. Note: if additional adults living in the same household would like to receive their own donation envelopes, they will need to fill out their own Registration Form. (Donations made by envelope or by separate check are recorded for tax purposes.) *

Tithing/Offering Envelopes. Note: if additional adults living in the same household would like to receive their own donation envelopes, they will need to fill out their own Registration Form. (Donations made by envelope or by separate check are recorded for tax purposes.) Please send envelopes Do NOT send envelopes
Name of Head of Household Name of Head of Household * First Last
Gender *

Gender Male Female
Date of Birth Date of Birth * / MM / DD YYYY
Religion *
Occupation
Primary Email *
Secondary Email
Cell Phone Cell Phone * - ### - ### ####
Home Phone Home Phone - ### - ### ####
Work Phone Work Phone - ### - ### ####
Name of Spouse or Domestic Partner (Phone Number Required for this person; fill in below) Name of Spouse or Domestic Partner (Phone Number Required for this person; fill in below) First Last
Cell Phone Cell Phone - ### - ### ####
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Occupation
Primary Email
Secondary Email
Home Phone Home Phone - ### - ### ####
Work Phone Work Phone - ### - ### ####
Other Adult # 1 in Household
Other Adult # 1 in Household
First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Occupation
Primary Email
Secondary Email
Cell Phone Cell Phone - ### - ### ####
Home Phone Home Phone - ### - ### ####
Work Phone Work Phone - ### - ### ####
Other Adult # 2 in Household
Other Adult # 2 in Household
First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Occupation
Primary Email
Secondary Email
Cell Phone Cell Phone - ### - ### ####
Home Phone Home Phone - ### - ### ####
Work Phone Work Phone - ### - ### ####
Children under 18 years old living in the home
Name of Child # 1 Name of Child # 1 First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Grade in School
Sacraments
Check appropriate boxes

Sacraments
Check appropriate boxes Already Baptized NEEDS Baptism Already Made First Communion NEEDS First Communion Already Confirmed NEEDS Confirmation
Name of Child # 2 Name of Child # 2 First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Grade in School
Sacraments
Check appropriate boxes

Sacraments
Check appropriate boxes Already Baptized NEEDS Baptism Already Made First Communion NEEDS First Communion Already Confirmed NEEDS Confirmation
Name of Child # 3 Name of Child # 3 First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Grade in School
Sacraments
Check appropriate boxes

Sacraments
Check appropriate boxes Already Baptized NEEDS Baptism Already Made First Communion NEEDS First Communion Already Confirmed NEEDS Confirmation
Name of Child # 4 Name of Child # 4 First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Grade in School
Sacraments
Check appropriate boxes

Sacraments
Check appropriate boxes Already Baptized NEEDS Baptism Already Made First Communion NEEDS First Communion Already Confirmed NEEDS Confirmation
Name of Child # 5 Name of Child # 5 First Last
Gender

Gender Male Female
Date of Birth Date of Birth / MM / DD YYYY
Religion
Grade in School
Sacraments
Check appropriate boxes

Sacraments
Check appropriate boxes Already Baptized NEEDS Baptism Already Made First Communion NEEDS First Communion Already Confirmed NEEDS Confirmation
OTHER CHILDREN: Please add names of other children, including their gender, birth date, religion, grade in school and which Sacraments have been received and which need to be received of Baptism, First Communion and/or Confirmation.
Other Optional Information: Please add any other information that you would like to share at this time of registration.

Parish Registration Form

Parish Registration Form

Children under 18 years old living in the home