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St. John Paul II Catholic Chapel Registration Form
Please fill in the form below to register as a parishioner. Our first Mass as a parish is July 3, 2022.
Previous Parish
*
Previous Parish City/State
*
Most likely Mass to Attend*
*
Sunday Morning, 9:00 AM
Sunday Morning*, 10:30 AM
Monday Morning, 7:15 AM
Wednesday 10:00 AM
Friday Morning, 7:15 AM
*Mass outdoors
Head of Household
Full Name
*
Mr.
Mrs.
Ms.
Dr.
Rev.
Br.
Sr.
Prefix
First Name
Middle Name
Last Name
Nickname
If applicable
Maiden Name
If applicable
Marital Status
*
Please Select
Married
Widowed
Separated
Divorced
Single
Married in the Catholic Church?
Yes
No
Anniversary Date
/
Month
/
Day
Year
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
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Occupation
If retired, prior primary occupation
Employer
Work Phone
Birth Date
*
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
*
Yes
No
As Catholic?
*
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
*
Yes
No
First Communion?
*
Yes
No
Confirmation?
*
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Spouse
Full Name
Mr.
Mrs.
Ms.
Dr.
Rev.
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
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Children (Living at Home)
Child #1
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #2
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #3
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #4
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #5
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
Parish Where Baptism Took Place
Used to track Sacraments
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
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Involvement in the Church
Liturgical Ministries
Altar Server
Wish to Join
Already Joined
Lector
Wish to Join
Already Joined
Usher
Wish to Join
Already Joined
Eucharistic Minister
Wish to Join
Already Joined
Communion to the Sick & Homebound
Wish to Join (once formed)
Sacristan and/or Assistant
Wish to Join
Already Joined
Flower or Altar Guild
Wish to Join
Already Joined
Mass Setup & Take Down (Outdoors)
Wish to Join
Already Joined
Instrumentalist/Music Ministry
Wish to Join
Already Joined
What Instrument(s) do you play?
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Involvement in the Church
Adoration of the Blessed Sacrament
Adoration Volunteer (Per Hour)
Interested in Signing Up: for an hour in the morning 8 AM - 12 PM
Interested in Signing Up: for an hour in the afternoon 12-3 PM
Hospitality Ministries
Mass Greeter
Wish to Join
Prayer Chain
Wish to Join
Religious Education
CGS Instructor/Catechist
Wish to Teach, Not Trained
Already Trained, Through Another Parish
I Have Child/Children I Would Like to Enroll in Religious Education (and Sacramental Preparation), Once Available.
Age 0-3
Age 3-6
Age 6-9
Age 9-12
Age 12-16
Age 16-18
Other
Marriage Preparation or RCIA Sponsor
Wish to Join
Technology & Communications
Data Entry/Parish Records
Wish to Join
Photography/Marketing
Wish to Join
Bulletin Folding & Preparation
Wish to Join
Activities & Fundraising
Second Sunday Fellowship: Coffee & Donuts
Wish to Join
Already Joined
Event Planning
Wish to Join
Is there a specific event you would like to help with?
Enter details here.
Outreach
Overall Outreach/Community Engagement/Outbound Calling & Emails
Wish to Join
Hospital & Homebound Visitations
Wish to Join
Parish Directory Authorizations
Publish Phone Number?
*
Yes
No
Publish Address?
*
Yes
No
Publish Email?
*
Yes
No
Signature
Today's Date
-
Month
-
Day
Year
Date
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