St. Clare of Assisi New Parishioner Registration
Family Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Email Address
*
example@example.com
Primary Phone
*
Please enter a valid phone number.
Phone Type
*
Please Select
Home
Mobile
Work
Head of Household Name
*
First Name
Last Name
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Religion
*
Catholic
Other
If other, please list denomination:
Sacraments Received
Baptism
First Communion
Confirmation
Marriage
None of the above
If Married, Were You Married in the Catholic Church?
Yes
No
Marital Status
*
Please Select
Single
Engaged
Married (in the Church)
Married (civil)
Divorced
Occupation/Profession/Skills or Retired From
Spouse's Information
Spouse Name
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Religion
*
Catholic
Other
If other, please list denomination:
Sacraments Received
Baptism
First Communion
Confirmation
Marriage
None of the Above
Occupation/Profession/Skills or Retired From:
Winter Visitors
Please only fill out this section if you are a seasonal resident of Arizona
Summer Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are You Registered At Your Summer Parish?
Yes
No
Parish Name
Tithing
I Want to Sign Up For Electronic Giving:
*
Yes, I'd like to self-enroll by going to faith.direct/AZ1084 or by texting "Enroll" to (623) 323-4424
No
I Want to Sign Up For Paper Envelopes
*
Yes, I'd like the Parish Office to assign me an envelope number and enroll me for paper envelopes.
No
Miscellaneous Information
Are You Registered At Another Parish in the Diocese of Phoenix?
*
Yes
No
If Yes, Which Parish?
Have You Completed Safe Environment in the Diocese of Phoenix?
*
Yes
No
No, In Another Diocese
I Don't Know
Please Share Any Additional Information About Your Family You Feel We Should Know:
Children/Dependents
Please list the children/dependents living with you. If they are no longer your dependent, are living on their own, or are married, they should register separately.
1st Child's Name:
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
My Child Has Received the Following Sacraments:
Baptism
First Communion
Confirmation
None of the Above
I Need Information About Faith Formation For This Child
Yes, please call or email me
No
2nd Child's Name:
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
My Child Has Received the Following Sacraments:
Baptism
First Communion
Confirmation
None of the Above
I Need Information About Faith Formation For This Child
Yes, please call or email me
No
3rd Child's Name:
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
My Child Has Received the Following Sacraments:
Baptism
First Communion
Confirmation
None of the Above
I Need Information About Faith Formation For This Child
Yes, please call or email me
No
4th Child's Name:
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
My Child Has Received the Following Sacraments:
Baptism
First Communion
Confirmation
None of the Above
I Need Information About Faith Formation For This Child
Yes, please call or email me
No
5th Child's Name:
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
My Child Has Received the Following Sacraments:
Baptism
First Communion
Confirmation
None of the Above
I Need Information About Faith Formation For This Child
Yes, please call or email me
No
If you have more than 5 children, please list their names, dates of birth, gender, and sacraments received in the box below:
Name of Other Family Members Living In the Home:
First Name
Last Name
Relationship:
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Name of Other Family Members Living In the Home:
First Name
Last Name
Relationship:
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Our Family Needs Accommodations In the Following Ways:
e.g. your child is on the ASD spectrum and needs headphones, your family member is non-speaking but fully participates in the liturgy, etc.
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Time & Talent
Our parish depends on the time and talent of parishioners like you! Please select any of the following ministries and someone will contact you with additional information:
Adult Bible Study
Altar Linen Society
Anima Christi Charismatic Prayer Group
Arts & Environment
Catholic Daughters of the Americas (Adults & Juniors)
Catholic Men's Fellowship
Christ Renews His Parish (Men)
Christ Renews His Parish (Women)
Cursillo
Cor Dialogue
Divine Mercy Cenacle
El Buen Pastor Oración Carismática
Extraordinary Minister of Holy Communion
Growing in Grace Women's Fellowship
Growing Together Garden Guild
Knights of Columbus
Knights of the Altar
Legion of Mary
Lector
Library Committee
Mary's Mantle
Men's Scripture Study
Metanoia
Music Ministry
Our Lady of Antipolo Ministry
Our Lady of Guadalupe Association
Prayer Shawl Ministry
Prison Ministry
Religious Education Catechist
Religious Education Aide
Rosary Makers
Sacristan
Safety Committee
St. Martha's Meals
St. Maximilian Kolbe Fraternity
Saturday Evening Fellowship
Small Christian Communities
Society of St. Vincent de Paul
Sorority of Lisieux
Walking With Moms in Need
Women's Guild
Submit
Should be Empty: