Church Membership Template

Parishioner Registration Form
ADULT 1*

Last First, Middle
Select One*

Head of HouseholdSpouseAdult
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Ethnicity
Religion
Sacraments Received*

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

Last First, Middle
Select One

Head of HouseholdSpouseAdult
Gender

MaleFemale
Date of Birth

MonthDayYear
Ethnicity
Religion
Sacraments Received

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

PrefixNumber
Family Status

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
Sacraments (Select all that apply)

Baptism1st Communionconfirmation
Child No. 2

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Sacraments (Select all that apply)

Baptism1st Communionconfirmation
Child No. 3

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Sacraments (Select all that apply)

Baptism1st Communionconfirmation
Child No. 4

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Sacraments (Select all that apply)

Baptism1st Communionconfirmation
Child No. 5

First, MiddleLast
Birthdate

MonthDayYear
Date
Grade
Ethnicity
Sacraments (Select all that apply)

Baptism1st Communionconfirmation
Would you like to receive donation envelopes?

YesNo
Would you like to information to sign up for on-line giving?

YesNo
Volunteers are needed for parish ministries. Please indicate which ministry you would like to volunteer for. Thank you.
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Parishioner Registration Form