St. Francis Catholic Church Registration Form

St. Francis Catholic Church

Welcome to our parish!

Family Name and Home Mailing Address
Last Name *
Street Address *
City *
State *
Zip *
Home Phone Number
Emergency Phone Number
Family email

Confirmation Email Please confirm the email address

Is it okay to publish your information in the St. Francis Directory? *

	Yes	No
Phone Number
Email
Address

What method would you like to use to support St. Francis parish?

Envelopes E-giving
Individual Member Information

Male of household
Name
Role (head of house, husband, etc)
(head of house, husband, brother, etc.)
Date of Birth

Month Day Year
Date
Email address
example@example.com
Cell Phone Number
Occupation
Catholic?

Yes No
If not Catholic, what is your religious affiliation?
What Sacraments have you received?

Baptism Reconciliation First Communion Confirmation

Female of household
Name
Maiden Name
Role (head of house, wife, etc)
(head of house, wife, sister, etc.)
Date of Birth

Month Day Year
Date
Email
example@example.com
Cell Phone Number
Occupation
Catholic?

Yes No
If not Catholic, what is your religious affiliation?
What Sacraments have you received?

Baptism Reconciliation First Communion Confirmation

Family & Dependent Information
Type a question

Married Divorced Separated Widowed Single Other
Are you married in the Catholic Church?

Yes No
Date of marriage

Month Day Year
Date
Dependent Information

Dependent #1
Name #1
Date of Birth

Month Day Year
Date
Gender

Male Female
Sacraments Received

Baptism Reconciliation First Communion Confirmation

Dependent #2
Name #2
Date of Birth

Month Day Year
Date
Gender

Male Female
Sacraments Received

Baptism Reconciliation First Communion Confirmation

Dependent #3
Name #3
Gender

Male Female
Date of Birth

Month Day Year
Date
Sacraments Received

Baptism Reconciliation First Communion Confirmation

Dependent #4
Name #4
Gender

Male Female
date of birth

Month Day Year
Date
Sacraments Received

Baptism Reconciliation First Communion Confirmation

Dependent #5
Name #5
Gender

Male Female
date of birth

Month Day Year
Date
Sacraments received

Baptism Reconciliation First Communion Confirmation

Dependent #6
Name #6
Gender

Male Female
date of birth

Month Day Year
Date
Sacraments received

Baptism Reconciliation First Communion Confirmation

Dependent #7
Name #7
Gender

Male Female
date of birth

Month Day Year
Date
Sacraments received

Baptism Reconciliation First Communion Confirmation

Dependent #8
Name #8
Gender

Male Female
date of birth

Month Day Year
Date
Sacraments received

Baptism Reconciliation First Communion Confirmation

General Information
Former parish community
(name of parish, city, state)
What brought you to St. Francis?
(i.e. moved, friend attends here, specific ministry, etc.)
Are there any ministries you would like to be involved in?
Any comments or questions?
Should be Empty: