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 Name
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Primary Phone --
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Home Address
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Head of Household 1
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HOH1 Date of Birth //
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HOH1 Gender
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HOH1 Maiden Name
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HOH1 Employer & Occupation
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If Retired, please state former occupation
HOH1 Secondary Phone --
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Email Address
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Do you want to receive newsletters and messages via email?
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Do you want to receive the weekly bulletin via email?
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HOH1 Religion
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HOH1 Baptized
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HOH1 Confirmed
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HOH1 Marital Status
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Marriage Date //
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Marriage Blessed in Catholic Church
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Name of Church//location of Wedding
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please indicate Name and location (include City/State) of Church married at. If not married in Church, indicate City/State.
Head of Household 2
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HOH2 Date of Birth //
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HOH2 Gender
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HOH2 Maiden Name
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HOH2 Employer & Occupation
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If retired, please state former occupation
HOH2 Secondary Phone --
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HoH2 E-mail
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HOH2: Do you want to receive newsletters and messages via email?
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HOH2: Do you want to receive the weekly bulletin via email?
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HOH2 Religion
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HOH2 Baptized?
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HOH2 Confirmed?
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First and Last Names of Child(ren) in Household
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Please provide each child's name, DOB, Gender, School, grade, religion & Church of Baptism.
Are you intending to send your child/children to Catholic elementary school
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First and Last Name(s) of Other Adult(s) in Household
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Is this information:
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Which contribution method will you be using?
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Would you be interested joining Parish ministries, activities or groups?
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Please select which ministries or activities you would like to receive information about:
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