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PARISH REGISTRATION FORM

Required

Date Registered
Must contain a date in M/D/YYYY format
Prefixrequired
Marital Statusrequired
Birthdaterequired
Must contain a date in M/D/YYYY format
Namerequired
First Name
Middle (optional)
Last Name
Addressrequired
City
State
Zip
Email Address
Primary Phone numberrequired
(xxx)-xxx-xxxx (Must contain only numbers)
Primary number
Alternate Phone number
(xxx)-xxx-xxxx (Must contain only numbers)
Alternate number
Occupation
Employer
LanguagePlease select up to 2 choices
Please select up to 2 choices
Other languages spoken

SACRAMENTS RECEIVED:

Baptism
Date
Must contain a date in M/D/YYYY format
Communion
Date
Must contain a date in M/D/YYYY format
Confirmation
Date
Must contain a date in M/D/YYYY format
Marriage
Date
Must contain a date in M/D/YYYY format

OTHER ADULT LIVING AT HOME

Prefixrequired
Relationship
Birthdate
Must contain a date in M/D/YYYY format
Name
First Name
Middle
Last Name
Email Address
Primary Phone number
(xxx)-xxx-xxxx (Must contain only numbers)
Primary number
Alternate Phone number
(xxx)-xxx-xxxx (Must contain only numbers)
Alternate number
Occupation
Employer
LanguageChoose up to 2
Choose up to 2
If other, please type your preferred language(s)required
Sacraments received:
Baptism
Date
Must contain a date in M/D/YYYY format
Communion
Date
Must contain a date in M/D/YYYY format
Confirmation
Date
Must contain a date in M/D/YYYY format
Marriage
Date
Must contain a date in M/D/YYYY format

CHILDREN INFORMATION

Name of First Child
First Name
Nickname
Middle
Last Name
Sex
Date of Birth
Must contain a date in M/D/YYYY format
Grade
Lives at Home
Address or Name of School if away at School
Name of Second Child
First Name
Nickname
Middle
Last Name
Sex
Date of Birth
Must contain a date in M/D/YYYY format
Grade
Lives at Home
Address or Name of School if Away at school
Name of Third Child
First Name
Nickname
Middle
Last Name
Sex
Date of Birth
Must contain a date in M/D/YYYY format
Grade
Lives at Home
Address or Name of School if away at school
Name of Fourth Child
First Name
Nickname
Middle
Last Name
Sex
Date of Birth
Must contain a date in M/D/YYYY format
Grade
Lives at Home
Address or Name of School if away at school
Are there more children
Please fill out information on additional children
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