Parish Registration Form

Parishioner Registration Form

Today's Date:

Family Name:

Mailing Name (e.g. Mr. and Mrs. Smith)

Street Address

City

State

ZIP

Primary Family Phone #

Primary Registrant (PR) - First Name

PR - Maiden Name (if applicable)

PR - Date of Birth

PR - Phone #

PR - Email

PR - Religion

PR - Employer/Occupation

PR - Education (Degree & Institution)

PR - Any Special Needs?

PR - Baptism (Date & Parish)

PR - First Communion (Date & Parish)

PR - Confirmation (Date & Parish)

Current Marital Status

Date of Marriage

Church Name/Location where married

Spouse - First Name

Spouse - Maiden Name (if applicable)

Spouse - Date of Birth

Spouse - Phone #

Spouse - Email

Spouse - Religion

Spouse - Employer/Occupation

Spouse - Education (Degree & Institution)

Spouse - Any Special Needs?

Spouse - Baptism (Date & Parish)

Spouse - First Communion (Date & Parish)

Spouse - Confirmation (Date & Parish)

Child (dependent) #1 - Name

Child (dependent) #1 - Gender

Child (dependent) #1 - Date of Birth

Child (dependent) #1 - School/Grade

Child (dependent) #1 - Please list the Sacraments your child has received ( Baptism, First Communion, & Confirmation) including dates and parish(es)/locations.

Child (dependent) #2 - Name

Child (dependent) #2 - Gender

Child (dependent) #2 - Date of Birth

Child (dependent) #2 - School/Grade

Child (dependent) #2 - Please list the Sacraments your child has received ( Baptism, First Communion, & Confirmation) including dates and parish(es)/locations.

Child (dependent) #3 - Name

Child (dependent) #3 - Gender

Child (dependent) #3 - Date of Birth

Child (dependent) #3 - School/Grade

Child (dependent) #3 - Please list the Sacraments your child has received ( Baptism, First Communion, & Confirmation) including dates and parish(es)/locations.

Child (dependent) #4 - Name

Child (dependent) #4 - Gender

Child (dependent) #4 - Date of Birth

Child (dependent) #4 - School/Grade

Child (dependent) #4 - Please list the Sacraments your child has received ( Baptism, First Communion, & Confirmation) including dates and parish(es)/locations.

If you have more than four children, please include the above information for each additional child below.