St. Elizabeth Ann Seton Parish Registration

St. Elizabeth Ann Seton Parish Registration

If you have problems completing this form contact us at 859-273-1318
Are you?*

New to the Church--Registering in the ParishAlready registered--updating my informationMoving or Leaving the ParishOther Please Fill The Reason Below
Would you like someone to contact you?*

YesNoContact Immediately by someone at the parish
Family Name*
Name you wish to appear on mailings, etc.
Mailing Address*
Street, City, State, Zip Code
Primary Contact Name*
First, Middle, Last
Primary Contact's Email Address*
example@example.com
Primary Contact's Phone Number*
Please enter a valid phone number.
Preferred Method of Contact

Phone/TextEmail
Primary Contact's Sex/Gender

MaleFemale
Primary Contact's Date of Birth

MonthDayYear
Date
Primary Contact's Occupation/Place of Work
Example: Salesman/Acme Co.
Primary Contact's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
Baptism Date (if known)

MonthDayYear
Date
First Communion Date (if known)

MonthDayYear
Date
Confirmation Date (if known)

MonthDayYear
Date
List Primary's past or current ministries
Marital Status
Wife's Maiden Name (Sometimes needed for parish records)
Location of Marriage Ceremony--Parish (if applicable)--City, State
Examples: St. Mary's--Springfield, KY or St. John's Lutheran--Dearborn, IN or Outdoors--Miami Beach, FL
If either party was/is Catholic, is the marriage sacramental? (Did it occur in a parish or another location with proper permission of the local bishop?)
If marriage occured at a Catholic Church--yes If marriage occured w/dispensation from bishop--yes If marriage was civil only--no, if unsure--select unknown
Fiancé's name--First Middle Last
Anticipated date of marriage celebration (if known)

MonthDayYear
Date
Date Married

MonthDayYear
Date
Spouse's Name--First Middle Last
Spouse's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
Spouse's Baptism Date (if known)

MonthDayYear
Date
Spouse's First Communion Date (if known)

MonthDayYear
Date
Spouse's Confirmation Date (if known)

MonthDayYear
Date
Spouse's Phone Number
Please enter a valid phone number.
Spouse's Email
example@example.com
Spouse's Occupation/Place of Work
Example: Salesman/Acme Co.
List Spouse's past or current ministries
Do you have children residing in your home?
Oldest Child's Name (First Middle Last)
Oldest Child's Sex/Gender
Oldest Child's Date of Birth

MonthDayYear
Date
Oldest Child's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
Oldest Child's School Attended/Grade
Example: Squires Elementary/3rd
Do you have additional children to register?
2nd Child's Name (First Middle Last)
2nd Child's Sex/Gender
2nd Child's Date of Birth

MonthDayYear
Date
2nd Child's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
2nd Child's School Attended/Grade
Example: Squires Elementary/3rd
Do you have additional children to register?
3rd Child's Name (First Middle Last)
3rd Child's Sex/Gender
3rd Child's Date of Birth

MonthDayYear
Date
3rd Child's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
3rd Child's School Attended/Grade
Example: Squires Elementary/3rd
Do you have additional children to register?
4th Child's Name (First Middle Last)
4th Child's Sex/Gender
4th Child's Date of Birth

MonthDayYear
Date
4th Child's Sacraments Completed (Select all that apply)

BaptismFirst CommunionConfirmation
4th Child's School Attended/Grade
Example: Squires Elementary/3rd
Do you have additional children to register?
If there are more than four (4) children residing with you use this section to include their information. (Include Name, Sex/Gender, Date of Birth, Sacraments Completed and School/Grade).
Special Notes: Use this space to indicate any special circumstances, ministry interest, etc. Also, include and special needs (disability, allergy, etc.)
Should be Empty: