Parish Registration Form

Parish Registration Form

Please fill out this form completely. ALL INFORMATION IS CONFIDENTIAL.
After entering all necessary information, make sure to CLICK SUBMIT at the bottom of the form to send. Thanks!
Last Parish attended in the Diocese of Raleigh - (if applicable):
Please notify your previous parish of your move.
FAMILY Last Name
Mailing Address

Street Address

Street Address 2

CityState

Zip Code
Preferred Phone

Area CodePhone Number
What type of phone is this?
Main E-mail

Confirmation Emailexample@example.com
Husband/Father/Male (Head of Household)
Are you Catholic?
Designation
First Name/Initial
What name do you like to be called?:
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What Sacraments have you received?
Marital Status:
Wedding Anniversary Date (if applicable)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Employer & Occupation
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Personal E-mail

Confirmation Email
Wife/ Mother/ Female (Head of Household)
Are you Catholic?
Designation
First Name/Initial
What name do you like to be called?:
Last Name (if different from Family Name listed above)
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What Sacraments have you received?
Marital Status:
Wedding Anniversary Date (if applicable)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Employer & Occupation
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail

Confirmation Email
Children

Please add your information for your child or children below. (Click to add a child after filling in Child #1, etc)
Child #1
Full Name

First NameMiddle NameLast Name
Sex
Goes by:
Date of Birth

MonthDayYear
Sacraments Received:
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?
Child #2
Full Name

First NameMiddle NameLast Name
Sex
Goes by:
Date of Birth

MonthDayYear
Sacraments Received:
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?
Child #3
Full Name

First NameMiddle NameLast Name
Sex
Goes by:
Date of Birth

MonthDayYear
Sacraments Received:
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?
Child #4
Full Name

First NameMiddle NameLast Name
Sex
Goes by:
Date of Birth

MonthDayYear
Sacraments Received:
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?
Child #5
Full Name

First NameMiddle NameLast Name
Sex
Goes by:
Date of Birth

MonthDayYear
Sacraments Received:
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Service Opportunities

Please check all service opportunities you are interested in. (place check box beside each item in the list below)
I am interested in the following:
Faith Formation
Should be Empty:

Parish Registration Form

Husband/Father/Male (Head of Household)

Wife/ Mother/ Female (Head of Household)

Children

Child #1

Child #2

Child #3

Child #4

Child #5

Service Opportunities