Parish Registration Form

1
Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number* This field is required.
Area Code
Phone Number
4
Work Phone Number
Area Code
Phone Number
5
Email
example@example.com
6
Would you like to receive text message and/or email updates from the parish?
Text
email
7
Date of Birth
Date
Month
Day
Year
8
Are you married?* This field is required.
YESNO
9
Spouse Name
First Name
Last Name
10
Spouse Date of Birth
Date
Month
Day
Year
11
Do you have children to register?* This field is required.
YESNO
12
Child's Name
First Name
Last Name
13
Birthdate
Date
Month
Day
Year
14
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
15
Do you have more children to register?
YESNO
16
Child's Name
First Name
Last Name
17
Birthdate
Date
Month
Day
Year
18
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
19
Do you have more children to register?
YESNO
20
Child's Name
First Name
Last Name
21
Birthdate
Date
Month
Day
Year
22
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
23
Do you have more children to register?
YESNO
24
Child's Name
First Name
Last Name
25
Birthdate
Date
Month
Day
Year
26
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
27
Do you have more children to register?
YESNO
28
Child's Name
First Name
Last Name
29
Birthdate
Date
Month
Day
Year
30
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
31
Do you have more children to register?
YESNO
32
Child's Name
First Name
Last Name
33
Birthdate
Date
Month
Day
Year
34
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
35
Do you have more children to register?
YESNO
36
Child's Name
First Name
Last Name
37
Birthdate
Date
Month
Day
Year
38
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
39
Do you have more children to register?
YESNO
40
Child's Name
First Name
Last Name
41
Birthdate
Date
Month
Day
Year
42
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
43
Do you have more children to register?
YESNO
44
Child's Name
First Name
Last Name
45
Birthdate
Date
Month
Day
Year
46
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
47
Do you have more children to register?
YESNO
48
Child's Name
First Name
Last Name
49
Birthdate
Date
Month
Day
Year
50
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
51
Do you have more children to register?
YESNO
52
Child's Name
First Name
Last Name
53
Birthdate
Date
Month
Day
Year
54
What sacraments has this child received?
Baptism
First Communion
Confirmation
Marriage
55
Are there other people that live in your household?* This field is required.
YESNO
56
Name
First Name
Last Name
57
Are there other people that live in your household?
YESNO
58
Name
First Name
Last Name
59
Are there other people that live in your household?
YESNO
60
Name
First Name
Last Name
61
Are there other people that live in your household?
YESNO
62
Name
First Name
Last Name
63
Are there other people that live in your household?
YESNO
64
Name
First Name
Last Name
65
Would you like to receive donation envelopes from the parish?* This field is required.
YESNO
66
Would you like to Sign up for automatic donations?* This field is required.
YESNO
67
Are you baptized?
YESNO
68
Is your spouse baptized?
YESNO
69
Have you received First Communion?
YESNO
70
Has your spouse received First Communion?
YESNO
71
Have you been Confirmed?
YESNO
72
Has your spouse been Confirmed?
YESNO
73
Are you married within the Catholic Church?
YESNO
74
When?
Date
Month
Day
Year
75
Where?Which church?
76
MinistriesWe encourage you to become active members of our parish. The following are a few of the ministries available to you. Please mark any that you may be interested in obtaining more information about or wish to participate in.
Liturgical Ministries (Lectors, Eucharistic Ministers, Altar Servers etc)
Religious Education (Elementary, Junior High, Confirmation etc)
Pre - Baptism Classes
Orders of Initiation for Adults (for adults interested in becoming full members of the Catholic Church)
Sacred Heart Office Volunteers
Ministry to the Elderly and Homebound
Youth Ministry
Fishes & Loaves / Peace & Justice Ministry
77
Signature* This field is required.
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