Parish Registration
3175 Hathaway Ct, Atlanta, GA 30341
FOR OFFICE USE ONLY:
PS Family DUID # _________
Envelope #___________
Today's Date
-
Month
-
Day
Year
Type
*
New Registration
Information Update
Family Name:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Email
example@example.com
Previous Parish
if applicable
Main Phone #
*
Would you like to receive the Catholic newspaper "Georgia Bulletin"?
Yes
No
Back
Next
Head of Household
*
First Name
Middle Name
Last Name
Gender
Male
Female
Birth Date
*
-
Month
-
Day
Year
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Emergency Phone Number
-
Area Code
Phone Number
Profession
Primary Language
Special Needs?
Are you Catholic?
*
Yes
No
Other
Sacraments Received
*
Baptism
First Communion
Confirmation
Catholic Marriage
None
Date of Catholic Marriage
-
Month
-
Day
Year
if applicable
Marital Status
Single
Married
Separated
Divorced
Annulled
Back
Next
Member #2
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Phone Number
-
Area Code
Phone Number
Emergency Phone Number
-
Area Code
Phone Number
Profession
Email
example@example.com
Special Needs?
Primary Language
Are you Catholic?
Yes
No
Other
Sacraments Received
Baptism
First Communion
Confirmation
Catholic Marriage
Date of Catholic Marriage
-
Month
-
Day
Year
if applicable
Marital Status
Single
Married
Separated
Divorced
Annulled
Back
Next
Member #3
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Back
Next
Member #4
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Back
Next
Member #5
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Back
Next
Member #6
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Back
Next
Member #7
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Back
Next
Member #8
First Name
Middle Name
Last Name
Relation to Head of Household
(Wife, Son, Daughter, Mother, etc.)
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Sacraments Received
Baptism
First Communion
Confirmation
Name of School
Special Needs?
Submit
Should be Empty: