Parish Registration Form

All dates should be written in this form: MM/DD/YYYY

All phone numbers should be written in this form AAA-EEE-XXXX

Use the Tab Key to move froim field to field

Type in N/A if the requested information does not apply

Family Information (Please complete all fields)

Today's Date
Click if you wish to receive Offertory envelopes
Envelope No.
Family (Last) Name
Mailing Address
State (use only USPS abbreviation)
Address (if different from mailing address)
Home Phone (include area code)

Members of the household


Name, first & middle (last if different from above)

Date of Birth M/F

Mairtal Status

Church Attendance Work Phone

Sacraments received (For First Communion, Confirmation and Penance, not only click the small box, but type in the date received in the big box, if known)

First Name Religion Church, City, State of Baptism Date Baptized First Communion Confirmation Penanace