IOP Parish Registration Form

IOP Parish Registration Form

Infant of Prague Church, 205 Chaney Ave., Jacksonville, NC 28540
We like to recognize our new members by publishing their names in the bulletin. Please indicate whether you would prefer your name to be published or not, by checking the appropriate box.*

YES, you may publish our namesNO, I do not wish to have our names published.
DATE:
LAST NAME:
MAILING ADDRESS:
CITY / ZIP CODE
PHONE NUMBER(S)
HOME:
CELL
EMAIL:
DO YOU WISH TO RECEIVE THE CHURCH CONTRIBUTION ENVELOPES?

YESNO
FAMILY INFORMATION

Please complete ALL information below - Please use proper names and not nicknames
HUSBAND
HUSBAND FULL NAME:
DATE OF BIRTH:

MonthDayYear
RELIGION:
OCCUPATION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
WIFE
WIFE FULL NAME:
DATE OF BIRTH:

MonthDayYear
RELIGION:
OCCUPATION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
MARITAL STATUS:

SingleMarried in the Catholic ChurchMarried outside the Catholic ChurchDivorcedDivorced with AnnulmentWidow / Widower
CHILDREN

PLEASE LIST ONLY CHILDREN UNDER THE AGE OF 21 LIVING IN THE HOME. CHILDREN OVER THE AGE OF 21 SHOULD REGISTER SEPARATELY AS ADULTS.
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:

BaptismCommunionConfirmationProfession of Faith
DISABILITIES:
My children are currently enrolled at Infant of Prague SchoolWe are interested in enrolling our children at Infant of Prague SchoolMy children are currently enrolled with Infant of Prague Faith Formation ProgramWe are interested in enrolling our children with Infant of Prague Faith Formation Program
IF AGE, ILLNESS OR OTHER FAMILY CIRCUMSTANCES WOULD PROHIBIT YOUR PARTICIPATION PLEASE INDICATE SO:
IS ANY MEMBER OF YOUR FAMILY HOMEBOUND

YesNo
FOR THOSE WHO ARE HOMEBOUND, WOULD YOU LIKE TO HAVE COMMUNION BROUGHT TO THEM IN THE HOME?

YesNo
MINISTRIES

PLEASE LIST THE NAME(S) OF THOSE INTERESTED IN SERVING:
LITURGICAL MINISTRIES:
ALTAR SERVER
LECTOR or COMMENTATOR
EUCHARISTIC MINISTER
HOSPITALITY MINISTER
FORMATION PROGRAMS
SCHOOL VOLUNTEER
FAITH FORMATION CATECHIST / AIDE / VOLUNTEER
RCIA TEAM MEMBER (RITE OF CHRISTIAN INITIATION OF ADULTS)
RCIA SPONSOR
PARISH COMMITTEES, GROUPS / ORGANIZATIONS
PARISH COUNCIL
FINANCE COUNCIL:
THRIFT SHOP VOLUNTEER
THRIFT SHOP WAREHOUSE VOLUNTEER
FUNDRAISERS
SENIOR YOUTH GROUP
KNIGHTS OF COLUMBUS
CATHOLIC DAUGHTERS
JR. CATHOLIC DAUGHTERS
RESPECT LIFE MINISTRY
50+ CLUB
REMINDER: Registration forms that have not been completed in full will be returned for completion
Should be Empty: