Parish Registration Form

Member Information
1st Adult's Full Name *

Prefix First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status *
Work Phone

Area Code Phone Number
Cell Phone *

Area Code Phone Number
E-mail *
Ethnicity
Sacramental Record Information
Gender *
Birth Date *

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for Converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

Member Information
2nd member's Full Name *

Prefix First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status *
Work Phone

Area Code Phone Number
Cell Phone *

Area Code Phone Number
E-mail *
Ethnicity
Sacramental Record Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for Converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

Member Information
3rd member's Full Name *

Prefix First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status *
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for Converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

4th member's full name *

First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status *
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for Converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

5th member's Full Name *

First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

6th Member's Full Name *

First Name Middle Name Last Name
Occupation
Maiden Name
Marital status
Cell phone

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for converts) None
Date of marriage (if applicable)
Religion
Would you like to register another family member? *

7th member's Full Name *

First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for converts) None
Date of Marriage (if applicable)
Religion
Would you like to register another family member? *

8th members's Full Name *

First Name Middle Name Last Name
Occupation
Maiden Name
Marital Status
Work Phone

Area Code Phone Number
Cell Phone

Area Code Phone Number
E-mail
Ethnicity
Sacramental Information
Gender *
Birth Date

Month Day Year
Sacrament(s) Celebrated *

Baptism Reconciliation Eucharist Confirmation Marriage Profession of Faith (for converts) None
Date of Marriage (if applicable)
Religion

Your registration is almost complete, but your journey at Prince of Peace is just beginning. A member of our Newcomers Ministry should be contacting you soon to welcome you personally to the parish and to tell you about the upcoming newcomers social. This is a great opportunity to meet some new people and learn a little bit about your new parish home.
THANK YOU!
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Family Information (Please complete for each member of your household)