New Parishioner Registration Form

(Please complete all of the applicable blanks and click on the submit button at the bottom of the form)


Street Address               City             State               Zip            

Mailing Address (if different)    City   State   Zip

Home Phone   Email (His)   Email (Hers)

Former Parish    City & State 

______________________________________________________________________________________________________________

Male / Husband

First Name     Last Name      Birth Date       

Languages spoken other than English   Religion

Baptized          Confirmed          Occupation   

Employer    Work Phone Education

______________________________________________________________________________________________________________

Female / Wife

First Name     Last Name       Birth Date      

Maiden Name

Languages spoken other than English   Religion

Baptized          Confirmed          Occupation  

Employer    Work Phone Education

______________________________________________________________________________________________________________

Marital Status

  Date of Marriage   Married by a Catholic Priest?

If divorced, have you applied for an annulment through the Catholic Church   

Was it granted?        Date

______________________________________________________________________________________________________

(Please only register children who reside with you)

Child 1      First Name     Last Name         Birth Date  

              Bapt. Date      Bapt. Place    1st. Comm  

              Confirmation        School         Grade  

_______________________________________________________________________________________________________

Child 2      First Name     Last Name     Birth Date    

              Bapt. Date      Bapt. Place     1st. Comm  

              Confirmation         School        Grade  

______________________________________________________________________________________________________

Child 3      First Name    Last Name      Birth Date  

              Bapt. Date      Bapt. Place     1st. Comm  

              Confirmation           School          Grade   

   _____________________________________________________________________________________________________

Child 4      First Name    Last Name      Birth Date  

              Bapt. Date      Bapt. Place     1st. Comm  

              Confirmation           School          Grade     

______________________________________________________________________________________________________

Child 5       First Name    Last Name      Birth Date  

              Bapt. Date      Bapt. Place     1st. Comm  

              Confirmation           School          Grade 

______________________________________________________________________________________________________

Child 6       First Name    Last Name      Birth Date  

              Bapt. Date      Bapt. Place     1st. Comm  

              Confirmation           School          Grade