Parish Registration

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

Family Info
Family Name
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Mailing Address
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Status:
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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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Other Preferred Means of Communication? Please list here.
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Is this information:
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Your Information
Your Information:
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Date of Birth //
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Gender
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Religion
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Date of Baptism  
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Occupation
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Employed by:
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Work Phone -- ext
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E-mail
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Spouse's Information
Spouse's Name
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Date of Birth //
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Gender
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Religion
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Date of Baptism  
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Occupation
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Employed by:
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Work Phone -- ext
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E-mail
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Information for Children Under 21 Living
1st Child
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Date of Birth //
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Religion
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Date of Baptism  
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2nd Child
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Date of Birth //
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Religion
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Date of Baptism  
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3rd Child
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Date of Birth //
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Religion
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Date of Baptism  
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4th Child
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Date of Birth //
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Religion
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Date of Baptism  
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Ministries
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List any special ministries your family may be willing to share.
Non-Catholic Members
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If any non-Catholic member of your household is interested in the Catholic Faith, please list their name and contact information.
Nursing Home Visit
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Is anyone in your household in a local nursing home? If yes, please list their name and which nursing home.
Home Bound
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If anyone in your household is unable to get to church and would like to receive Holy Communion at home, please list their name here.
Publish My Name and Address in Parish Publications
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For security purposes, please enter the text that appears in the box below.
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