Parish Registration

Thank you for taking time to register your household's information with our parish office. Please fill out the form as completely as possible and then click submit.

Household Information
Family Name
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First Name(s)
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Address
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Primary Phone --
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Secondary Phone --
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Email Address
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Alternative Email Address
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Is this information:
  •  
Head of Household Information
Parish Status
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Role
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First Name
  •  
Nickname
  •  
Gender
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Maiden Name
  •  
 if applicable
Date of birth //
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E-mail
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Work Phone -- ext
  •  
Cell Phone --
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First Language
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Occupation
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Employer
  •  
Sacramental Information
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Marital Status
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Valid Catholic Marriage?
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Dates of Sacraments Received
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 Please give the dates (if known) for sacraments checked above.
Second Adult Information
Parish Status
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Role
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Name
  •  
Nickname
  •  
Gender
  •  
Maiden Name
  •  
Date of birth //
  •  
E-mail
  •  
Work Phone -- ext
  •  
Cell Phone --
  •  
First Language
  •  
Occupation
  •  
Employer
  •  
Sacramental Information
  •  
Marital Status
  •  
Valid Catholic Marriage?
  •  
Dates of Sacraments Received
  •  
 Please give the dates (if known) for sacraments checked above.
1st Dependent Child Information
Relationship to Head of Household
  •  
Name
  •  
Gender
  •  
Date of Birth //
  •  
Birthplace
  •  
Year of High School Graduation
  •  
School Currently Attending
  •  
First Language
  •  
Check if Sacrament Received
  •  
Dates of Sacraments
  •  
 Please give the dates (if known) for sacraments checked above.
2nd Dependent Child Information
Relationship to Head of Household
  •  
Name
  •  
Gender
  •  
Date of Birth //
  •  
Birthplace
  •  
Year of High School Graduation
  •  
School Currently Attending
  •  
First Language
  •  
Check if Sacrament Received
  •  
Dates of Sacraments
  •  
 Please give the dates (if known) for sacraments checked above.
More people to add?
Names
  •  
 List names of additional adults or children in your household.
A member of our staff will get in touch with you to get the information for the additional people named above. Please indicate below when and how you would like to be contacted.
I prefer
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Contact Instructions
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Thank You
Are there any members of your household who would like to be visited by a priest?
  •  
You are almost done! Don't forget to click "Submit" below.
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