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Parishioner Registration Form
Please fill in the form below.
Please specify your church
*
Holy Ghost
St. Bernadette
Please specify your membership status
*
New Member
Existing Member
Previous Parish
Previous Parish City/State
Most likely Mass to Attend
Saturday Evening, 5 p.m. (St. Bernadette)
Sunday Morning, 9 a.m. (Holy Ghost)
Sunday Morning, 11 a.m. (St. Bernadette)
Weekdays at 7 a.m. or 8 a.m. (either location)
Head of Household
Full Name
*
Mr.
Mrs.
Ms.
Dr.
Rev.
Br.
Sr.
Prefix
First Name
Middle Name
Last Name
Nickname
If applicable
Maiden Name
If applicable
Marital Status
*
Please Select
Married
Widowed
Separated
Divorced
Single
Married in the Catholic Church?
Yes
No
Anniversary Date
/
Month
/
Day
Year
E-mail
*
If none, type "none"
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
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Occupation
If retired, prior primary occupation
Employer
Work Phone
Format: (000) 000-0000.
Birth Date
*
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
*
Yes
No
As Catholic?
*
Yes
No
First Reconciliation?
*
Yes
No
First Eucharist?
*
Yes
No
Confirmation?
*
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Spouse
Full Name
Mr.
Mrs.
Ms.
Dr.
Rev.
Prefix
First Name
Middle Name
Last Name
Nickname
If applicable
Maiden Name
If applicable
Cell Phone
Format: (000) 000-0000.
E-mail
example@example.com
Occupation
If retired, prior primary occupation
Employer
Work Phone
Format: (000) 000-0000.
Birth Date
/
Month
/
Day
Year
Mother's Maiden Name
Used to track Sacraments
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Children (Living at home)
Child #1
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Elementary or High School
If applicable
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #2
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Elementary or High School
If applicable
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #3
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Elementary or High School
If applicable
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #4
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Elementary or High School
If applicable
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
Child #5
Full Name
First Name
Middle Name
Last Name
Nickname
If applicable
Gender
Male
Female
Birth Date
/
Month
/
Day
Year
Elementary or High School
If applicable
Year in School
Please Select
Pre-K 3
Pre-K 4
K
1
2
3
4
5
6
7
8
9
10
11
12
College
Baptized?
Yes
No
As Catholic?
Yes
No
First Reconciliation?
Yes
No
First Eucharist?
Yes
No
Confirmation?
Yes
No
RCIA?
Yes
No
Current Religion
What year?
About what year?
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Involvement in the Church
Liturgical Ministries
Altar Server
Wish to Join
Already Joined
For Who?
Enter details here.
Lector
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For Who?
Enter details here.
Eucharistic Minister
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For Who?
Enter details here.
Communion to the Sick & Homebound
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For Who?
Enter details here.
Sacristan and/or Assistant
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For Who?
Enter details here.
Choir
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For Who?
Enter details here.
Instrumentalist
Wish to Join
Already Joined
For Who?
Enter details here.
What Instrument(s) do you play?
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Parish Directory Authorizations
Publish Phone Number?
*
Yes
No
Publish Address?
*
Yes
No
Publish Email?
*
Yes
No
Parish Communications
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