SCB-KC Parish Registration

When sending correspondence, how should we address the mailing label?

Family Name

Address

City State Zip

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

(check one)

Head of Household Title

Head of Household Marital Status

Head of Household Religious Denomination

Spouse Title

Spouse Marital Status

Spouse Religious Denomination

Adults of the Household

Rows	Head of Household	Spouse
Name (first/middle/Last)
Sex (type Male of Female)
Birthdate
Preferred Name
Home Phone
Work Phone
Fax
Pager
Cellular Phone
Email Addresss
Marriage Date
Occupation
Employerr
Baptism Received (mm/dd/yy)
Eucharist Received (mm/dd/yy)
Reconciliation Received (mm/dd/yy)
Confirmation Received (mm/dd/yy)

Children

Rows	Child 1	Child 2	Child 3
Name (first/middle/Last)
Sex (type M for male and F for Female)
Birthdate
Preferred Name
School
Current Grade
Baptism Received (mm/dd/yy)
Eucharist Received (mm/dd/yy)
Reconciliation Received (mm/dd/yy)
Confirmation Received (mm/dd/yy)

Children

Rows	Child 4	Child 5	Child 6
Name (first/middle/Last)
Sex (type M for male and F for Female)
Birthdate
Preferred Name
School
Current Grade
Baptism Received (mm/dd/yy)
Eucharist Received (mm/dd/yy)
Reconciliation Received (mm/dd/yy)
Confirmation Received (mm/dd/yy)

Family Income (check one)

For questions, please call the Parish Office at (816) 436-0880.

Membership Profile