Parish Registration Form

Parish Registration Form

Please fill out this form completely. ALL INFORMATION IS CONFIDENTIAL.
FAMILY Last Name
Home Phone

Area Code Phone Number
Mailing Address

Street Address

Street Address Line 2

City State

Zip Code
Adult #1 (Head of Household)
First Name/Initial
Goes by:
Occupation
Date of Birth

Month Day Year
Date
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail *

Confirmation Email
Adult #2 (Spouse)
First Name/Initial
Goes by:
Occupation
Date

Month Day Year
Date
Work Phone:

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail

Confirmation Email
Marriage Questions
Marital Status

Single Married Divorced Widowed Cohabitating
Date of Marriage

Month Day Year
Type of Marriage

Marriage recognized by Catholic Church Marriage outside of Catholic Church Civil Marriage Only
Household Questions

Please write information clearly. Enter Number of people in your household.
Number of People in Household ( The fields will appear based on your selection.)

1 2 3 4 5 More than 5
Head of Household
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Spouse
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Child #1
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Child #2
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Child #3
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Confirmation

Yes No
Child #4
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Child #5
First Name & Initial
Goes by:
Relationship (Son, Daughter, etc.)
Date of Birth

Month Day Year
Religion
Baptism

Yes No
First Eucharist

Yes No
Confirmation

Yes No
Are you interested in information on our ministries and groups?

Yes No Maybe
I am interested in the following:

Lectors Ushers Altar Servers Music Ministry-Choir Hospitality Committee-social after Mass Visiting Sick/Shut-Ins Food preparation for special events Church Decorations (Christmas, Easter, etc) CCD- Children Sursum Corda-Youth Group RCIA-Adults Yard Work on Church Property Food Preparation for Funerals Cleaning Church Pews Right to Life Apostolate Knights of Columbus
May we send you information on automatic draft giving?

Yes No
How many years have you been at Sacred Heart Parish?
Is there a shut-in at your address?

Yes No
If yes, please name..
Should be Empty:

Parish Registration Form

Adult #1 (Head of Household)

Adult #2 (Spouse)

Marriage Questions

Household Questions

Head of Household

Spouse

Child #1

Child #2

Child #3

Child #4

Child #5