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Parish Registration
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Name – Head of Household
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Last
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School Name (if enrolled)
Degree / Current Grade
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Place of Employment / Business Phone
Baptism
Yes
No
Baptism Date
MM slash DD slash YYYY
Church, City, State
First Penance
Yes
No
Confirmation
Yes
No
Confirmation
Yes
No
Sacrament of Matrimony
Yes
No
Sacrament of Matrimony – Date
MM slash DD slash YYYY
Church, City, State
Spouse
Name – Spouse
First
Last
Email
Date of Birth
MM slash DD slash YYYY
Marriage Status
Single
Divorced
Separated
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Annulled
Handicap / Disability (if any)
Current Religion
School Name (if enrolled)
Degree / Current Grade
Occupation
Place of Employment / Business Phone
Baptism
Yes
No
Baptism Date
MM slash DD slash YYYY
Church, City, State
First Penance
Yes
No
First Communion
Yes
No
Confirmation
Yes
No
Sacrament of Matrimony
Yes
No
Sacrament of Matrimony – Date
MM slash DD slash YYYY
Church, City, State
Children
Number of Children
0
1
2
3
Child 1
Child 1
First
Last
Email
Date of Birth
MM slash DD slash YYYY
Handicap / Disability (if any)
Current Religion
School Name (if enrolled)
Degree / Current Grade
Occupation
Baptism
Yes
No
Baptism Date
MM slash DD slash YYYY
Church, City, State
First Penance
Yes
No
First Communion
Yes
No
Confirmation
Yes
No
Child 2
Child 2
First
Last
Email
Date of Birth
MM slash DD slash YYYY
Handicap / Disability (if any)
Current Religion
School Name (if enrolled)
Degree / Current Grade
Occupation
Baptism
Yes
No
Baptism Date
MM slash DD slash YYYY
Church, City, State
First Penance
Yes
No
First Communion
Yes
No
Confirmation
Yes
No
Child 3
Child 3
First
Last
Email
Date of Birth
MM slash DD slash YYYY
Handicap / Disability (if any)
Current Religion
School Name (if enrolled)
Degree / Current Grade
Occupation
Baptism
Yes
No
Baptism Date
MM slash DD slash YYYY
Church, City, State
First Penance
Yes
No
First Communion
Yes
No
Confirmation
Yes
No
Additional Information
Please check each of the areas below that my be of interest to you or a family member or about which you would like additional information.
Religious Education
Eucharistic Minister
Adult Education
Choir (Adult/Youth)
Becoming a Catholic (RCIA)
Cantor
Youth Ministry
Instrumentalist
Teen Ministry
Sponsor Couple for the Engaged
Lector
Faith Sharing Groups
Usher
Legion of Mary
Altar Server
St. Vincent De Paul Society
Greeter
St. Ann’s Society
Parish Life Committee
Scouts
Children’s Liturgy of the Word
Baptism Preparation
Funeral Team
Ministry to the Homebound
Bereavement
Sunday Coffee Socials (Rel Ed)
Other
Please Note: Checking any area does not commit you to a particular activity.
Please indicate here any questions, concerns or needs that you or a member of your family has in which the parish may be able to help.
Homebound
Pastoral Counseling
Anointing the sick
Home visit
Annulment
House blessing
Someone to phone me
Marriage convalidation
Other
All information will be held in strictest confidence.
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