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 Information
Mailing Name (ie Mr. & Mrs. John Doe)
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Home 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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Envelope#
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Other Preferred Means of Cummincation? Please list here.
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Is this information:
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Individual Member Information
Role (head of household, Husband, Wife, etc.)
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First Name/Nickname:
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Gender
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Maiden Name
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Date of Birth //
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E-mail
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Cell Phone --
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First Language
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Occupation/Employer
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Sacramental Info:
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Baptism //
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Reconciliation //
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Eucharist //
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Confirmation //
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Marital Status
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Valid Catholic Marriage
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Role (head of household, Husband, Wife, etc.)
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First Name/Nickname:
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Gender
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Maiden Name
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Date of Birth //
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E-mail
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Cell Phone --
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First Language
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Occupation/Employer
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Sacramental Info:
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Baptism //
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Reconciliation //
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Eucharist //
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Confirmation //
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Dependent/Children Information
1. Relationship to Head of Household
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First Name
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Last Name
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Birthdate //
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Birthplace
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High School Grad Month/Year  
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School
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First Language
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Sacramental Info:
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Baptism //
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Eucharist //
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Reconciliation //
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Confirmation //
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2. Relationship to Head of Household
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First Name
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Last Name
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Birthdate //
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Birthplace
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High School Grad Month/Year  
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School
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First Language
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Sacramental Info:
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Baptism //
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Eucharist //
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Reconciliation //
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Confirmation //
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3. Relationship to Head of Household
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First Name
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Last Name
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Birthdate //
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Birthplace
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High School Grad Month/Year  
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School
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First Language
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Sacramental Info:
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Baptism //
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Eucharist //
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Reconciliation //
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Confirmation //
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Message

To add additional members please use a second form.

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