Our Lady of Lourdes Parish Registration Form
General Information
Email
*
example@example.com
Last Name
*
First Name(s)
*
enter your first name - or names if a couple (i.e., John & Jane)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone (If Applicable, Cell Phone Number Listed Below)
-
Area Code
Phone Number
Male Information
Male Name
First Name
Last Name
My Friends Call Me
Title
Mr.
Dr.
Date of Birth
Languages Spoken (if other than English)
Religion
Baptized
Yes
No
Occupation/Employer
Cell Phone
-
Area Code
Phone Number
Email, if different than above (male)
Female Information
Female Name
First Name
Last Name
Maiden Name
My Friends Call Me
Title
Mrs.
Ms.
Miss
Dr.
Date of Birth
Languages Spoken (If other than English)
Religion
Baptized
Yes
No
Occupation/Employer
Cell Phone
-
Area Code
Phone Number
Email, if different than above (female)
Marital Status
Marital Status
Married
Single
Widowed
Divorced
Were you Married by a Catholic priest?
Yes
No
Children
Type a question
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Gender (M/F)
First Name
Last Name
Birth Date
Baptismal Date
Place of Baptism
1st Communion
Confirmation
School Attending
Grade
Parish History
Are You New to this Area?
Yes
No
Previous Location
Previous Church Attended
What Brings you to Pittsburg?
Does your immediate family (those who live in your house) Currently Attend Mass at Our Lady of Lourdes?
Yes
No
Does anyone in your immediate family participate in any ministries/activities at Our Lady Of Lourdes? If yes, which ones?
Are you registering at a Parish for the first time?
Yes
No
ARE YOU OR YOUR SPOUSE AN ALUMNUS OF ST. MARY’S COLGAN CATHOLIC SCHOOLS?
Male Graduation Year/Female Graduation Year
I WOULD LIKE MORE INFORMATION ABOUT THE FOLLOWING (check all that apply)
Schools
Adoratoin
Parish Ministries
RCIA (Classes for those adults wishing to enter the Catholic church.
Submit
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