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

City State

Zip Code
Main Phone *

Area Code Phone Number
What type of phone is this?
Main E-mail *

Confirmation Email example@example.com
Husband/Father/Male (Head of Household)
Are you Catholic?

Yes No
Designation
First Name/Initial
What name do you like to be called?:
Date of Birth

Month Day Year
Date
What Sacraments have you received?

Baptism Holy Communion Confirmation
Marital Status:
Wedding Anniversary Date (if applicable)

Month Day Year
Date
Employer & Occupation
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
Personal E-mail

Confirmation Email
Wife/ Mother/ Female (Head of Household)
Are you Catholic?

Yes No
Designation
First Name/Initial
What name do you like to be called?:
Last Name (if different from Family Name listed above)
Date

Month Day Year
Date
What Sacraments have you received?

Baptism Holy Communion Confirmation
Marital Status:
Wedding Anniversary Date (if applicable)

Month Day Year
Date
Employer & Occupation
Work Phone:

Area Code Phone Number
Cell Phone:

Area Code Phone 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 Name Middle Name Last Name
Sex
Goes by:
Date of Birth

Month Day Year
Sacraments Received:

Baptism Holy Communion Confirmation
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?

Yes No
Child #2
Full Name

First Name Middle Name Last Name
Sex
Goes by:
Date of Birth

Month Day Year
Sacraments Received:

Baptism Holy Communion Confirmation
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?

Yes No
Child #3
Full Name

First Name Middle Name Last Name
Sex
Goes by:
Date of Birth

Month Day Year
Sacraments Received:

Baptism Holy Communion Confirmation
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?

Yes No
Child #4
Full Name

First Name Middle Name Last Name
Sex
Goes by:
Date of Birth

Month Day Year
Sacraments Received:

Baptism Holy Communion Confirmation
Date and Church of Baptism:
Date and Church of First Communion:
Date and Church of Confirmation:
Would you like to add another child?

Yes No
Child #5
Full Name

First Name Middle Name Last Name
Sex
Goes by:
Date of Birth

Month Day Year
Sacraments Received:

Baptism Holy Communion Confirmation
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:

Altar Servers Lectors Ushers Music Ministry-Choir Right to Life Apostolate Knights of Columbus Hospitality Committee Decorating Church for Holidays Cleaning Church Pews Yard Work on Church Property Food Preparation for Funerals
Faith Formation

Faith Formation-Children Sursum Corda- Yout Group RCIA- Adults
Should be Empty:

Parish Registration Form

Husband/Father/Male (Head of Household)

Wife/ Mother/ Female (Head of Household)

Children

Child #2

Child #3

Child #4

Child #5

Service Opportunities