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.
DATE:
LAST NAME:
MAILING ADDRESS:
CITY / ZIP CODE
PHONE NUMBER(S)
HOME:
CELL
EMAIL:
DO YOU WISH TO RECEIVE THE CHURCH CONTRIBUTION ENVELOPES?
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:
DISABILITIES:
WIFE
WIFE FULL NAME:
DATE OF BIRTH:

MonthDayYear
RELIGION:
OCCUPATION:
SACRAMENTS:
DISABILITIES:
MARITAL STATUS:
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:
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:
DISABILITIES:
CHILD FIRST NAME:
LAST NAME (if different than parent):
DATE OF BIRTH

MonthDayYear
RELIGION:
SACRAMENTS:
DISABILITIES:
IF AGE, ILLNESS OR OTHER FAMILY CIRCUMSTANCES WOULD PROHIBIT YOUR PARTICIPATION PLEASE INDICATE SO:
IS ANY MEMBER OF YOUR FAMILY HOMEBOUND
FOR THOSE WHO ARE HOMEBOUND, WOULD YOU LIKE TO HAVE COMMUNION BROUGHT TO THEM IN THE HOME?
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 STORE VOLUNTEER
THRIFT STORE WAREHOUSE VOLUNTEER
FUNDRAISERS
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: