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  • Parish Registration Status New Update Withdrawing from Parish
  • Household Information
    • LAST NAME REQUIRED Please fill out this field. Please enter valid data.
    • Street Address REQUIRED Please fill out this field. Please enter valid data.
    • City REQUIRED Please fill out this field. Please enter valid data.

      State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

      Zip REQUIRED Please fill out this field. Please enter a zip code.
    • Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
    • Cell Phone Number Please enter a phone number.
  • Relationship Status Married Single Divorced Co-Habitants Widowed
  • • Primary Adults In Household (Please list up to two primary adults under this section. Any additional adults in the household should be listed under Children/other Adults) REQUIRED Please fill out this field.
    • Adult 1
      • First Name Please enter valid data.
      • Maiden Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Occupation Please enter valid data.
      • Email Please enter an email address.
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name for Sacraments Please enter valid data.
      • Notations Please enter valid data.
    • Adult 2
      • First Name Please enter valid data.
      • Maiden Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Occupation Please enter valid data.
      • Email Please enter an email address.
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name for Sacraments Please enter valid data.
      • Notations Please enter valid data.
  • Marriage
    • Date of Marriage Please enter a date.
    • City Please enter valid data.

      State None AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

      Zip Please enter a zip code.
    • Place Please enter valid data.
    • Notation - first marriage, annulments, if married outside the Catholic Church was marriage blessed, etc. Please enter valid data.
  • • Children (or other adults living with you) REQUIRED Please fill out this field.
    • Child/Adult 1
      • First & Last Name Please enter valid data.
      • Relationship Please enter valid data.
      • Date of Birth Please enter a date.
      • Male/Female None Male Female
      • Occupation Please enter valid data.
      • School Name Please enter valid data.
      • Grade Level None Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 College
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name Sacraments Received Please enter valid data.
    • Child/Adult 2
      • First & Last Name Please enter valid data.
      • Relationship Please enter valid data.
      • Date of Birth Please enter a date.
      • Male/Female None Male Female
      • Occupation Please enter valid data.
      • School Name Please enter valid data.
      • Grade Level None Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 College
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name Sacraments Received Please enter valid data.
    • Child/Adult 3
      • First & Last Name Please enter valid data.
      • Relationship Please enter valid data.
      • Date of Birth Please enter a date.
      • Male/Female None Male Female
      • Occupation Please enter valid data.
      • School Name Please enter valid data.
      • Grade Level None Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 College
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name Sacraments Received Please enter valid data.
    • Child/Adult 4
      • First & Last Name Please enter valid data.
      • Relationship Please enter valid data.
      • Date of Birth Please enter a date.
      • Male/Female None Male Female
      • Occupation Please enter valid data.
      • School Name Please enter valid data.
      • Grade Level None Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 College
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name Sacraments Received Please enter valid data.
    • Child/Adult 5
      • First & Last Name Please enter valid data.
      • Relationship Please enter valid data.
      • Date of Birth Please enter a date.
      • Male/Female None Male Female
      • Occupation Please enter valid data.
      • School Name Please enter valid data.
      • Grade Level None Pre-K Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 College
      • Sacraments Received Baptism First Communion Confirmation
      • Church Name Sacraments Received Please enter valid data.
  • I/We usually attend Mass at REQUIRED 4:30 p.m Vigil 8:00 a.m. 10:00 a.m. 12:00 p.m. (noon) Please fill out this field.
  • Budget Envelope Information
    • Budget Envelope Information REQUIRED I receive Budget Envelopes (please record number below) I receive Budget Envelopes, but do not know my number I do not receive Budget Envelopes, but would like to I am not interested in receiving a Budget Envelope Please fill out this field.
    • Budget Envelope Number Please enter valid data.
  • I am interested in the following Parish activities RCIA (Right of Christian Initiation for Adults) Religious Education (Grades K through 12) Altar Server (Grade 3 thru 12) Altar Server - Adult Church Bazaar Committee Choir - Adult Choir - Children (Grades 1 thru 12) Church Decor Eucharistic Minister Knights of Columbus Lectoring Legion of Mary Prayer Line Volunteer Pro-life Group Simon Ministry Spirited Seniors St. Vincent de Paul Society

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