St. Ann and Our Lady of the Assumption Online Registration Form
Please select which Church you are registering for:
*
St. Ann Catholic Church (Gulf Breeze, FL)
Our Lady of the Assumption (Pensacola Beach, FL)
Please complete this form for Family Information. If there are members in your household 21 years of age or older, we encourage them to register separately.
Click
HERE
to download a printable copy of this form to send to office.
Last Name (Please do not include suffixes, professional designations or other extraneous information in the last name field.)
*
First Name (Main Head of Household)
*
Middle Name
Head of Household"s E-Mail
*
Date of Birth
-
Month
-
Day
Year
Date
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
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Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guadeloupe
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Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Mailing Address (Leave blank if the same as your home address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone (ex- 8509322859, no dashes)
2nd Phone
Special Needs
Comments
Would you like the parish to send you Parish Envelopes for Tithing?
*
Send Contribution Envelopes
Do NOT Send Contribution Envelopes
If you E-Tithe you do not need envelopes but you may check here if you still want to receive.
At this time, we are also asking for your permission to publish your phone number, e-mail address or mailing address in our parish directory and on various other correspondences. Please check all those that we may publish
*
Publish Phone
Publish E-Mail
Publish Address
Do NOT Publish Anything
Back
Next
How many total family members are you registering for St. Ann or Our Lady of the Assumption?
*
1
2
3
4
5
6
7
8
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by a Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of the RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Back
Next
Individual Registration Information for Family Member
The following information is requested for each member in a household. If there are members in the household over the age of 21 we encourage them to register separately.
Please fill out the below individual registration for each family member. After you are done registering each family member click next until you get to the last page, and then click "submit".
Gender
*
Male
Female
Adult
Child
Title
Please Select
Mr.
Mrs.
Ms.
Miss
Dr.
Last Name
*
First Name
*
Middle Name
Suffix
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
Date
Language
2nd Language
Religion
E-Mail
Home Phone
Cell Phone
Occupation
Work Phone
Fax Number
Baptism
Date of Baptism
-
Month
-
Day
Year
Date
Church Name
City, State
If not Catholic list Religion
1st Communion
Date of 1st Communion
-
Month
-
Day
Year
Date
Church Name
City, State
1st Reconciliation
Date of 1st Reconciliation
-
Month
-
Day
Year
Date
Church Name
City, State
Confirmation
Date of Confirmation
-
Month
-
Day
Year
Date
Church Name
City, State
RCIA Process
Date of RCIA Process
-
Month
-
Day
Year
Date
Church Name
City, State
Matrimony
Date of the Matrimony
-
Month
-
Day
Year
Date
Church Name
City, State
Wife"s Maiden Name
Check if Married by Priest or Deacon
Submit
Should be Empty: