ST. RENE GOUPIL PARISH REGISTRATION

St. Rene Goupil Parish Family Registration

35955 Ryan Rd. Sterling Heights, MI 48310
FAMILY LAST NAME*
PHONE NUMBER*
Format: (000) 000-0000.
EMERGENCY PHONE NUMBER*
Format: (000) 000-0000.
ADDRESS*
CITY*
STATE*
ZIP CODE*
EMAIL*
example@example.com
ENVELOPE #
ROLE:MR.MRS.MS.MISSROLE:MR.MRS.MS.MISS
INDIVIDUAL (PERSON 1) FIRST NAME*
MaleFemale
DATE OF BIRTH*

MonthDayYear
Date
LANGUAGE
PHONE NUMBER*
Format: (000) 000-0000.
CELL PHONE NUMBER
Format: (000) 000-0000.
EMAIL*
example@example.com
YESNO
BAPTISMFIRST EUCHARISTCONFIRMATION
ROLE:MR.MRS.MS.MISSROLE:MR.MRS.MS.MISS
INDIVIDUAL(PERSON 2) FIRST NAME
DATE OF BIRTH

MonthDayYear
Date
MaleFemale
LANGUAGE
PHONE NUMBER
Format: (000) 000-0000.
CELL PHONE NUMBER
Format: (000) 000-0000.
EMAIL
example@example.com
YESNO
BAPTISMFIRST EUCHARISTCONFIRMATION
Dependant Children Information
(DEPENDANT 1) FIRST NAME
MaleFemale
DATE OF BIRTH

MonthDayYear
Date
BAPTISMFIRST EUCHARISTCONFIRMATION
(DEPENDANT 2)FIRST NAME
MaleFemale
DATE OF BIRTH

MonthDayYear
Date
BAPTISMFIRST EUCHARISTCONFIRMATION
(DEPENDANT 3)FIRST NAME
MaleFemale
DATE OF BIRTH

MonthDayYear
Date
BAPTISMFIRST EUCHARISTCONFIRMATION
Should be Empty: