Parishioner Registration Form

Spouse / Additional Adult Information
Spouse / Additional Adult Prefix

Other
Spouse / Additional Adult Name

First NameLast Name
Spouse / Additional Adult Cell Phone
Format: (000) 000-0000.
Spouse / Additional Adult Alternate Phone
Format: (000) 000-0000.
Spouse / Additional Adult Email Address
example@example.com
Spouse / Additional Adult Date of Birth

MonthDayYear
Date
Spouse / Additional Adult Religion

Dependent Children Living at Home
Are there any dependent children living in the home?
Dependent Child in the Home - 1
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Date of Birth

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 2
Name of Dependent Child Living in the Home
First name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Date of Birth

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 3
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Date of Birth

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 4
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Date of Birth

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 5
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Date of Birth

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 6
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Birth Date

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 7
Name of Dependent Child Living in the Home
First name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Birth Date

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 8
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Birth Date

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 9
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Birth Date

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)
Do you need to add an additional Dependent Child living in the home?
Dependent Child in the Home - 10
Name of Dependent Child living in the home
First Name / Last Name
Gender
Relationship to Head of Household
Religion
Edit if necessary
Grade Level
Birth Date

MonthDayYear
Year Baptized (if applicable)
Year Received First Reconciliation (if applicable)
Year Received First Communion (if applicable)
Year Received Confirmation (if applicable)

Address Information
Mailing Address

Mailing Address

Street Address Line 2

CityState

Zip Code
Secondary Address (if applicable)

Secondary Address

Street Address Line 2

CityState

Zip Code

Miscellaneous Information
How would you prefer to tithe?
May we publish photos of your family members participating in parish activities?
Are any family members homebound?
Name and relationship of homebound family member
Any additional comments or information that the office should be aware of:
Should be Empty:

Parishioner Registration Form

Head of Household Information

Spouse / Additional Adult Information

Dependent Children Living at Home

Dependent Child in the Home - 1

Dependent Child in the Home - 2

Dependent Child in the Home - 3

Dependent Child in the Home - 4

Dependent Child in the Home - 5

Dependent Child in the Home - 6

Dependent Child in the Home - 7

Dependent Child in the Home - 8

Dependent Child in the Home - 9

Dependent Child in the Home - 10

Address Information

Miscellaneous Information