Parishioner Registration Form

PARISH REGISTRATION FORM

St. Mary's Roman Catholic Church, 62 Warren St., Glens Falls, NY 12801
Are You...? *

NEW to St. Mary's Church UPDATING your existing parish record
Head of Household
Head of Household's Name *

Prefix First Name Last Name Suffix
Date of Birth *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Preferred Email Address *
Preferred Phone Number *
Phone Type *

Cell Phone Land Line
Preferred method of communication *

E-Mail Text US MAIL
Would you like to receive envelopes? *

Yes No
The Evangelist newspaper (it's FREE) *

I currently receive The Evangelist I would like to receive The Evangelist I do not wish to receive The Evangelist

SACRAMENTS received by Head of Household

Spouse's SACRAMENTS

Children in Household

Family Needs / Additional Info.

Please use the box below to let us know if anyone has special needs to which we should be attentive or if there is anything else we should know that wasn't covered in the previous questions.
Additional Information

PARISH REGISTRATION FORM