Member Registration Form

Today's Date

Date

Membership Requested

Do you currently receive The Record Archdiocesan Newspaper?

Name (person filling out this form)

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date

MonthDayYear

Religion

Marital Status

Is Your Spouse Joining the Parish with You?

Date of Marriage

Date

Spouse's Name

First NameLast Name

Spouse's Email

example@example.com or N/A

Spouse's Phone Number

Area CodePhone Number

Birth Date of Spouse

MonthDayYear

Spouse's Religion

What Sacraments Have You Received

Rows	Yes	Church Name	City
Baptism
First Communion
Confirmation
Matrimony
None

What Sacraments Has Your Spouse Received

Rows	Yes	Church Name	City
Baptism
First Communion
Confirmation
Matrimony
None

Employer

Spouse's Employer

Occupation

Spouse's Occupation

We Choose to Make Our Contribution by:

Other

*If you signed up to be a member at both St. Brigid & St. James, you will receive envelopes for both parishes.

Please Refer to Giving Menu on the Website for Online Giving Instructions

In recognition and thankfulness that we have each been blessed by God, I/we have prayerfully decided that we will contribute.

Dollars or Undecided

In recognition and thankfulness that we have each been blessed by God, I/we have prayerfully decided that we will contribute
$ * .

Contribution

Other

Which Mass Do You Primarily Attend

Get Involved

Rows	Self	Spouse
Eucharistic Minister
Lector
Sacristan
Greeter/Host
Worship Committee
Coffee & Donuts - Hospitality
Cantor
Music Ministry/Choir
AGIFT
Prayer Blanket
Social Adult Ministry/Events
Knights of Columbus
Bible Study
Respect Life
Eucharistic Outreach
Highland Young Adult Catholic
St. Vincent de Paul
Fundraisers & Volunteer Opportunities
Parish Office Help
Undecided

Children under the age of 21 living with you (anyone in your household over the age of 21 needs to register on their own).

Do You Have Children Under 21

Add Another Child

Is Anyone In Your Family In Need of Sacraments? If Yes, Please Check Below and You Will Be Contacted