Parish Registration Status *New ParishionerPhone ChangeAddress ChangeName ChangeEmail Change Registrant First: Middle: Last: Maiden (if applicable): Address: Apt #: City: State: Zip: Day Phone #: Evening Phone #: Cell Phone #: Email: Occupation: Gender:—Please choose an option—MaleFemale Religion: Birth Date: Marital Status:—Please choose an option—SingleMarriedSeparatedDivorcedAnnulledWidowed Marriage Witnessed By Catholic Priest:—Please choose an option—YesNo Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Children Attend School:YesNo Number of Children At Home: Spouse First: Middle: Last: Maiden (if applicable): Day Phone #: Evening Phone #: Cell Phone #: Email: Occupation: Gender:—Please choose an option—MaleFemale Religion: Birth Date: Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Children living in your home (under the age of 18 years) [Anyone over 18 is considered an adult in the Catholic Church and should register separately] Add a child Child 1 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 2 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 3 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 4 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 5 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 6 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 7 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 8 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Add a child Child 9 First: Middle: Last (if different): Gender:—Please choose an option—MaleFemale Religion: Birth Date: School Attending: Languages Spoken: Handicaps if any? Baptism:YesNo Reconciliation:YesNo First Communion:YesNo Confirmation:YesNo Are You Human? Δ
