Parish Registration Form-Family

New Parishioner Registration Form
I am registering:*

Just myselfMyself and my SpouseMyself and my Child(ren)Myself, my Spouse, and my Child(ren)
Please complete all information for yourself.
First Name*
Middle Name*
Last Name*
Maiden Name: If female please provide for sacramental records.
Best Phone at Which to Reach You:*
What Type of Phone is the Above:*

HomeWorkCell
Address *
City*
State*
ZIP Code*
Email*
Ethnicity
Occupation:*
Employer:*
Date of Birth:*

MonthDayYear
Date
Baptism*
Date received and name of church, city, and state (include all info. that you know)
First Reconciliation*
Date received and name of church, city, and state (include all info. that you know)
First Eucharist*
Name of church, city, and state (include all info. that you know)
Confirmation*
Name of church, city, and state (include all info. that you know)
If you are interested in becoming involved with a Parish Ministry or Organization, please visit the St. Leo website at Parish Ministries and contact the individual Ministry leaders for the group or ministry in which you are interested. Some ministry leaders change often and this is the most efficient way to contact the correct person. If you need additional assistance from the Church Office, please contact us at 336-724-0561 or info@stleocatholic.org.
Would you like to have donation envelopes mailed to you?

Yes, please put me on the mailing list for envelopes.No, I will make donations via Online Giving at www.stleocatholic.org
If single, you may scroll to the end and click on Submit. If married, please complete all information in this section. Keep scrolling in order to enter information on your child(ren).
Date of Marriage:

MonthDayYear
Location of Marriage:
Name of Church/Location, City and State
Catholic Marriage?

YesNo
Spouse's First Name
Spouse's Middle Name
Spouse's Last Name
Maiden Name: If female please provide for sacramental records.
Do you use your Maiden name as last name?
Date of Birth:

MonthDayYear
Date
Ethnicity
Occupation:
Employer:
Spouse's Baptism
Date received and name of church, city, and state (include all info. that you know)
Spouse's First Reconciliation
Date received and name of church, city, and state (include all info. that you know)
Spouse's First Eucharist
Date received and name of church, city, and state (include all info. that you know)
Spouse's Confirmation
Date received and name of church, city, and state (include all info. that you know)
Please list children under the age of 18 - oldest to youngest. Include only one child per box. Please list the following (when applicable):

Full Name
Birth date
Grade Level
Baptism Date and Location
First Communion Date and Location
First Penance Date and Location
Confirmation Date and Location
*If you need more space, please continue in the Additional Comments section
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Check any/all areas of interest for your child(ren):

Altar ServerBoy/Cub ScoutsBrownies/Girl ScoutsFaith FormationSt. Leo Catholic SchoolVacation Bible SchoolYouth Ministry
Do you or any of your family members have any sacramental/spiritual needs of which St. Leo should be made aware? (i.e. blessing of a marriage, marriage preparation, baptism, procurement of a Matrimonial annulment, etc.)
Additional Comments:
Should be Empty:

New Parishioner Registration Form