St Elizabeth Ann Seton Catholic Church - Parish Registration Form

Parish Registration Form

St Elizabeth Ann Seton Catholic Church | 4600 Belle Terre Pkwy, Palm Coast, FL 32164 | www.seaspcfl.org
Please complete the below with as much information as possible. If you have any questions please contact the parish office at (386) 445-2246 or info@seaspcfl.org.

CLICK HERE TO RETURN TO SEAS WEBSITE
FAMILY INFORMATION
Today's Date

MonthDayYear
Family Last Name:*
Family Street Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Family Mailing Address (if different from street address above):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Family Email:*
example@example.com -- if you don't have an email address, please enter N/A
Family Primary Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Would you like contribution envelopes mailed to you or would you like to use our online giving option?*

Envelopes Mailed to MeOnline Giving Option
MEMBER INFORMATION
Head of Household #1 Name:*

First NameLast Name
Head of Household #1 Gender:*
Head of Household #1 Marital Status:*
Head of Household #1 Date of Birth:*

MonthDayYear
Date
Head of Household #1 Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Type of Phone:*

CellLandline
Head of Household #1 Email (if different from family email above):
example@example.com
Head of Household #1 Gender:*

MaleFemale
Head of Household #1 Sacraments Received:

BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
Head of Household #2 Name:

First NameLast Name
Head of Household #2 Gender:
Head of Household #2 Marital Status:
Head of Household #2 Date of Birth:

MonthDayYear
Date
Head of Household #2 Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Type of Phone:

CellLandline
Head of Household #2 Email (if different from family email above):
example@example.com
Head of Household #2 Gender:

MaleFemale
Head of Household #2 Sacraments Received:

BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
How many additional people are in the household?*
- Additional Adult/Child in Home #1 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #1 - Gender:
- Additional Adult/Child in Home #1 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #1 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #1 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Additional Adult/Child in Home #2 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #2 - Gender
- Additional Adult/Child in Home #2 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #2 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #2 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Additional Adult/Child in Home #3 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #3 - Gender
- Additional Adult/Child in Home #3 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #3 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #3 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Additional Adult/Child in Home #4 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #4 - Gender
- Additional Adult/Child in Home #4 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #4 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #4 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Additional Adult/Child in Home #5 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #5 - Gender
- Additional Adult/Child in Home #5 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #5 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #5 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Additional Adult/Child in Home #6 - Name:
  
  First NameLast Name
- Additional Adult/Child in Home #6 - Gender
- Additional Adult/Child in Home #6 - Date of Birth:
  
  MonthDayYear
  Date
- Relationship to Head of Household:
  e.g. child, sibling, other
- Additional Adult/Child in Home #6 Gender:
  
  MaleFemale
- Additional Adult/Child in Home #6 Sacraments Received:
  
  BaptismFirst Communion (Eucharist)ConfirmationCatholic Marriage
- Welcome to St. Elizabeth Ann Seton Catholic Church!
- Please complete by selecting SUBMIT. Once registration form is received, you will receive a Welcome Package with additional information on the Parish, Ministries, Contribution Giving, etc.
  
  If there are any additional questions, please do not hesitate to contact our office at (386) 445-2246 or info@seaspcfl.org.
  
  Welcome to St Elizabeth Ann Seton Catholic Church!
- Should be Empty:

Parish Registration Form

FAMILY INFORMATION

MEMBER INFORMATION

Welcome to St. Elizabeth Ann Seton Catholic Church!