Church Membership Template

Parishioner Registration Form
ADULT 1*

Last First, Middle
Head of HouseholdSpouseAdult
MaleFemale
Date of Birth*

MonthDayYear
Ethnicity
Religion
Baptism1st CommunionConfirmation
Occupation
E-mail*
Phone Number (please include area code)*
ADULT 2

Last First, Middle
Head of HouseholdSpouseAdult
MaleFemale
Date of Birth

MonthDayYear
Ethnicity
Religion
Baptism1st CommunionConfirmation
Occupation
E-mail
example@example.com
Mobile Phone Number

PrefixNumber
SingleMarried (In Church)Married (Civil Union)DivorcedWidowed
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Street Address (if different from mailing)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Church Attended
Child No.1 (under 18 yrs old)

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Baptism1st Communionconfirmation
Child No. 2

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Baptism1st Communionconfirmation
Child No. 3

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Baptism1st Communionconfirmation
Child No. 4

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Baptism1st Communionconfirmation
Child No. 5

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Baptism1st Communionconfirmation
YesNo
YesNo
Volunteers are needed for parish ministries. Please indicate which ministry you would like to volunteer for. Thank you.
Should be Empty:

Parishioner Registration Form