Parishioner Registration Form
Please fill out this form and click submit.
Family Information
Family Last Name
*
Family Address
*
Family Address City
*
Family Address State
*
Family Address ZIP
*
Family Email
*
This address will receive a confirmation email
Family Mobile Phone
*
Member 1 Information
Member 1 Last Name
*
Member 1 First Name
*
Member 1 Preferred Name
*
Member 1 Date of Birth
*
Member 1 Email
*
Member 1 Mobile Phone
*
Sacraments Received
*
Please select all that apply.
Baptism
First Communion
Confirmation
Marriage
Member 2 Information
Member 2 Last Name
Member 2 First Name
Member 2 Preferred Name
Member 2 Date of Birth
*
Member 2 Email
Member 2 Mobile Phone
Sacraments Received
Please select all that apply.
Baptism
First Communion
Confirmation
Marriage
Member 3 Information
Member 3 Last Name
Member 3 First Name
Member 3 Preferred Name
Member 3 Date of Birth
Sacraments Received
Please select all that apply.
Baptism
First Communion
Confirmation
Member 4 Information
Member 4 Last Name
Member 4 First Name
Member 4 Preferred Name
Member 4 Date of Birth
Sacraments Received
Please select all that apply.
Baptism
First Communion
Confirmation
Member 5 Information
Member 5 Last Name
Member 5 First Name
Member 5 Preferred Name
Member 5 Date of Birth
Sacraments Received
Please select all that apply.
Baptism
First Communion
Confirmation
Member 6 Information
Member 6 Last Name
Member 6 First Name
Member 6 Preferred Name
Member 6 Date of Birth
Sacraments Received
*
Please select all that apply.
Baptism
First Communion
Confirmation
Additional Information
Additional Information
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Description
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