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St. Pius X Catholic Church Registration Form

Directions: This form may be used to register as a new parishioner to our parish or to update your information as an existing parishioner.
Date*

MonthDayYear
Date
1051 Waggoner Road Reynoldsburg, OH 43068-9704Phone: 614-866-2859stpiusx@spxreynoldsburg.com
Type*

New RegistrationUpdate Information
FAMILY NAME (LAST NAME)*
ADDRESS*
City*
State*
ZIP + 4*
Email:
Phone*
PERSONAL INFORMATION
MALE ADULT - FIRST NAME
MI
DATE OF BIRTH

MonthDayYear
Date
RELIGION
BAPTISM
1st COMM.
CONFIRMATION
EMPLOYER
OCCUPATION
WORK PHONE
CELL PHONE
FEMALE ADULT - FIRST NAME
MI
DATE OF BIRTH

MonthDayYear
Date
RELIGION
BAPTISM
1st COMM.
MAIDEN NAME
CONFIRMATION
EMPLOYER
OCCUPATION
WORK PHONE
CELL PHONE
CURRENT MARITAL STATUS
Check One:
SINGLE

true
CHURCH MARRIAGE (Sacramental Catholic Marriage)

true
CIVIL MARRIAGE

true
DIVORCED

true
WIDOWED

true
DATE OF MARRIAGE

MonthDayYear
Date
PLACE of MARRIAGE (parish, church, court house, etc.)
City
State

St. Pius X Catholic Church Registration Form