Saint Elizabeth Ann Seton Catholic Church Registration Form

Full Name*

First NameMiddle NameLast Name
Nickname/Preferred Name
Sex*

MaleFemale
Date of Birth*

MonthDayYear
Place of Birth*
Please include country if born outside of the United States.
Preferred Phone Number*

PrefixNumber
Preferred E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Marital Status*

SingleEngagedMarriedWidowedDivorcedSeparated
Would you like someone to contact you regarding marriage prep or scheduling your marriage at St. Elizabeth Ann Seton and/or with one of our priests?

Yes, please!No, thank you.
Marriage Date*
Your/Spouses Maiden Name*
Were you married in the Catholic church?*

YesNo
Would you like someone to contact you regarding getting your marriage convalidated? (Convalidation is a ceremony in which a marriage, such as a civil marriage, is made recognized by the church.)*

Yes, please.No, thank you.
Your Religion*

CatholicOther
Which Sacraments have you received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your baptism?
What is the date of your First Communion?
What is the date of your Confirmation?
What Christian faith were you baptized into?
Are you registered at another parish in the Archdiocese of Anchorage?*

YesNo
Where are you registered?*
Would you like to transfer your registration to St. Elizabeth Ann Seton?*

Yes, we'd like to register here.No, we are only registering here for Faith Formation.
Are you registering other members of your immediate family? Check all that apply*

No, thanks.Yes, a spouseYes, a child2 children3 children4 children5 children6 children7 children8 children9 children10 childrenI have more than 10 children; please contact me for additional information
Spouse's Full Name*

First NameMiddle NameLast Name
Spouse's Place of Birth*
Spouse's Nickname/Preferred Name
Spouse's Date of Birth*

MonthDayYear
Spouse's Sex*

MaleFemale
Your Spouse's Religion*

CatholicOther
Which Sacraments have your spouse received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your spouse's baptism?
What is the date of your spouse's First Communion?
What is the date of your spouse's Confirmation?
What Christian faith was your spouse baptized into?
Child's Full Name*

First NameMiddle NameLast Name
Child's Date of Birth*

MonthDayYear
Child's Place of Birth*
Child's Sex*

MaleFemale
Which Sacraments have your Child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your child's baptism?
What is the date of your child's First Communion?
What is the date of your child's Confirmation?
What Christian faith was your child baptized into?
Second Child's Full Name*

First NameMiddle NameLast Name
Second Child's Date of Birth*

MonthDayYear
Second Child's Place of Birth*
Second Child's Sex*

MaleFemale
Which Sacraments have your second child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your second child's baptism?
What is the date of your second child's First Communion?
What is the date of your second child's Confirmation?
What Christian faith was your second child baptized into?
Third Child's Full Name*

First NameMiddle NameLast Name
Third Child's Date of Birth*

MonthDayYear
Third Child's Place of Birth*
Third Child's Sex*

MaleFemale
Which Sacraments have your third child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your third child's baptism?
What is the date of your third child's First Communion?
What is the date of your third child's Confirmation?
What Christian faith was your third child baptized into?
Fourth Child's Full Name*

First NameMiddle NameLast Name
Fourth Child's Date of Birth*

MonthDayYear
Fourth Child's Place of Birth*
Fourth Child's Sex*

MaleFemale
Which Sacraments have your fourth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your fourth child's baptism?
What is the date of your fourth child's First Communion?
What is the date of your fourth child's Confirmation?
What Christian faith was your fourth child baptized into?
Fifth Child's Full Name*

First NameMiddle NameLast Name
Fifth Child's Date of Birth*

MonthDayYear
Fifth Child's Place of Birth*
Fifth Child's Sex*

MaleFemale
Which Sacraments have your fifth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your fifth child's baptism?
What is the date of your fifth child's First Communion?
What is the date of your fifth child's Confirmation?
What Christian faith was your fifth child baptized into?
Sixth Child's Full Name*

First NameMiddle NameLast Name
Sixth Child's Date of Birth*

MonthDayYear
Sixth Child's Place of Birth*
Sixth Child's Sex*

MaleFemale
Which Sacraments have your sixth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your sixth child's baptism?
What is the date of your sixth child's First Communion?
What is the date of your sixth child's Confirmation?
What Christian faith was your sixth child baptized into?
Seventh Child's Full Name*

First NameMiddle NameLast Name
Seventh Child's Date of Birth*

MonthDayYear
Seventh Child's Place of Birth*
Seventh Child's Sex*

MaleFemale
Which Sacraments have your seventh child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your seventh child's baptism?
What is the date of your seventh child's First Communion?
What is the date of your seventh child's Confirmation?
What Christian faith was your seventh child baptized into?
Eighth Child's Full Name*

First NameMiddle NameLast Name
Eighth Child's Date of Birth*

MonthDayYear
Eighth Child's Place of Birth*
Eighth Child's Sex*

MaleFemale
Which Sacraments have your eighth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your eighth child's baptism?
What is the date of your eighth child's First Communion?
What is the date of your eighth child's Confirmation?
What Christian faith was your eighth child baptized into?
Ninth Child's Full Name*

First NameMiddle NameLast Name
Ninth Child's Date of Birth*

MonthDayYear
Ninth Child's Place of Birth*
Ninth Child's Sex*

MaleFemale
Which Sacraments have your ninth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your ninth child's baptism?
What is the date of your ninth child's First Communion?
What is the date of your ninth child's Confirmation?
What Christian faith was your ninth child baptized into?
Tenth Child's Full Name*

First NameMiddle NameLast Name
Tenth Child's Date of Birth*

MonthDayYear
Tenth Child's Place of Birth*
Tenth Child's Sex*

MaleFemale
Which Sacraments have your tenth child received? (check all that apply)*

Catholic BaptismChristian BaptismFirst Reconciliation/First CommunionConfirmationPlease contact me about receiving additional sacramentsNone of the Above
What is the date of your tenth child's baptism?
What is the date of your tenth child's First Communion?
What is the date of your tenth child's Confirmation?
What Christian faith was your tenth child baptized into?
Would you like to receive giving envelopes in the mail?

Yes, please.Not right now, thanks.
I am interested in the following (check all that apply):

I want my child in a faith formation program.I want my child to attend Saint Elizabeth Ann Seton Catholic school (grades Pre-K through 6)I am seeking sacraments.I am interested in learning more about becoming CatholicNone of theseOther
To learn more about the school, please visit www.akseas.com or call 907-345-3712.
Which sacraments?
Who is the sacrament for?
Other questions/comments/concerns/special needs:
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