Parish Registration Form

St Francis of Assisi Church
Parish Registration Form
Family Last Name*
Address*
PO Box
City*
Zip Code*
Home Phone*
Cell Phone
E Mail
Head of Household First Name*
Maiden or Last Name, if different
Date of Birth*

MonthDayYear
Date
Religion*
YesNo
Baptism Date

MonthDayYear
Date
Baptism Church
YesNo
YesNo
Spouse First Name
Maiden or last name, if different
Date of Birth

MonthDayYear
Date
Religion
YesNo
Baptism Dated

MonthDayYear
Date
Baptism Church
YesNo
YesNo
MarriedDivorcedSingleCohabit
Marriage Date

MonthDayYear
Date
Marriage Church
Adult/Child #1 First Name
Adult/Child #1 Maiden or Last Name, if different
Adult/Child #1 Birth date

MonthDayYear
Date
Adult/Child #1 Religion
Adult/Child #1 School Attending
YesNo
Adult/Child #1 Baptism Date

MonthDayYear
Date
Adult/Child #1 Baptism Church
YesNo
YesNo
Adult/Child #2 First Name
Adult/Child #2 Maiden or Last Name, if different
Adult/Child #2 Birth date

MonthDayYear
Date
Adult/Child #2 Religion
Adult/Child #2 School Attending
YesNo
Adult/Child #2 Baptism Date

MonthDayYear
Date
Adult/Child #2 Baptism Church
YesNo
YesNo
Adult/Child #3 First Name
Adult/Child #3 Maiden or Last Name, if different
Adult/Child #3 Birth date

MonthDayYear
Date
Adult/Child #3 Religion
Adult/Child #3 School Attending
YesNo
Adult/Child #3 Baptism Date

MonthDayYear
Date
Adult/Child #3 Baptism Church
YesNo
YesNo
Adult/Child #4 First Name
Adult/Child #4 Maiden or Last Name, if different
Adult/Child #4 Birth date

MonthDayYear
Date
Adult/Child #4 Religion
Adult/Child #4 School Attending
YesNo
Adult/Child #4 Baptism Date

MonthDayYear
Date
Adult/Child #4 Baptism Church
YesNo
YesNo
Please indicate any special needs
Parking available on Adam St. in school & rectory parking lots
Should be Empty:

St Francis of Assisi Church

Parish Registration Form

Parking available on Adam St. in school & rectory parking lots