Parish Registration Form

Address *

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. The date of the upcoming social is June 14th immediately following the Saturday Vigil Mass, we hope to see you there!

Prince of Peace makes available to parishioners a large number of Ministries through which they can share their time and talents to serve our community. If you would like to know more about the Ministries we offer, please refer to the contact information in our bulletin or to the Ministries section on our website
THANK YOU!
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Family Information (Please complete for each member of your household)