St. Patrick Registration Form

*

New Member

Previous Parish

Previous Parish City/State

Most likely Mass to Attend

Full Name *

Prefix First Name Middle Name Last Name

Nickname

If applicable

Maiden Name

If applicable

Marital Status *

Married in the Catholic Church?

Yes No

Anniversary Date

E-mail *

If none, type "none"

Home Phone *

If none, your primary contact number

Cell Phone

Address *

Street Address

Street Address Line 2

City State

Zip Code Country

Occupation

If retired, prior primary occupation

Employer

Work Phone

Birth Date *

Mother's Maiden Name

Used to track Sacraments

As Catholic? *

Yes No

Baptized? *

Yes No

Baptism Date & Location (Parish, City, State) (to the best of your knowledge)

First Reconciliation? *

Yes No

First Reconciliation & Location (Parish, City, State) (to the best of your knowledge)

First Communion? *

Yes No

First Communion & Location (Parish, City, State) (to the best of your knowledge)

Confirmation? *

Yes No

Confirmation & Location (Parish, City, State) (to the best of your knowledge)

RCIA?

Yes No

Current Religion

What year?

About what year?

Full Name

Prefix First Name Middle Name Last Name

Nickname

If applicable

Maiden Name

If applicable

Cell Phone

E-mail

Occupation

If retired, prior primary occupation

Employer

Work Phone

Birth Date *

Mother's Maiden Name

Used to track Sacraments

As Catholic? *

Yes No

Baptized? *

Yes No

Baptism Date & Location (Parish, City, State) (to the best of your knowledge)

First Reconciliation? *

Yes No

First Reconciliation & Location (Parish, City, State) (to the best of your knowledge)

First Communion? *

Yes No

First Communion & Location (Parish, City, State) (to the best of your knowledge)

Confirmation? *

Yes No

Confirmation & Location (Parish, City, State) (to the best of your knowledge)

RCIA?

Yes No

Current Religion

What year?

About what year?

Please list only those children who are under 18 and are living at home; other adults must register separately.

Registration Form

Head of Household

Spouse

Children

Involvement in the Church

Liturgical Ministries

Involvement in the Church

Prayer

Organizations

Formation

Hospitality Ministries

Parish Events

Outreach

Parish Directory Authorizations

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