New Parishioner Registration Form
(Please complete all of the applicable blanks and click on the submit button at the bottom of the form)
****Please do not submit this electronic registration if you have already completed paper registration****
Street Address City State Zip
Mailing Address (if different) City State Zip
Phone Email (His) Email (Hers)
Neighborhood / Development Name
Former Parish City & State
______________________________________________________________________________________________________________
Male / Husband
First Name Last Name Birth Date
Languages spoken other than English Religion
Baptized Y / N Yes No Confirmed Y / N Yes No Occupation
Employer Work Phone Education Select High School College Grad School
Female / Wife
Maiden Name
Marital Status
Please Select Single - Never Married Single - Divorced Single - Widowed Married Married - Previously Divorced Date of Marriage Married by a Catholic Priest? NA Yes No
If divorced, have you applied for an annulment through the Catholic Church NA Yes No
Was it granted? NA Yes No Date
______________________________________________________________________________________________________
(Please only register children who reside with you)
Child 1 M / F Male Female First Name Last Name Birth Date
Bapt. Date Bapt. Place 1st. Comm
Confirmation School Grade
_______________________________________________________________________________________________________
Child 2 M / F Male Female First Name Last Name Birth Date
Child 3 M / F Male Female First Name Last Name Birth Date
_____________________________________________________________________________________________________
Child 4 M/ F Male Female First Name Last Name Birth Date
Child 5 M / F Male Female First Name Last Name Birth Date
Child 6 M / F Male Female First Name Last Name Birth Date