Online Parish Registration

    Items with * are required.

    Family Information

    *Family Name:
    Street address:
    City:
    State:
    ZIP:
    Home phone:
    Would you like your phone number listed? (Yes/No):
    *Primary email:

    Adult Member Information

    Adult 1

    If you are single/unmarried, this is the only section you need to fill out.

    *First Name:
    Middle Name:
    *Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Occupation:
    Employer:
    Work Phone:
    Work E-mail:
    Cell Phone:
    Marital Status:
    Date of Wedding (MM/DD/YYYY):
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Adult 2

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Occupation:
    Employer:
    Work Phone:
    Work E-mail:
    Cell Phone:
    Marital Status:
    Date of Wedding (MM/DD/YYYY):
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Children

    Child 1

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Child 2

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Child 3

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Child 4

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Child 5

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    Child 6

    First Name:
    Middle Name:
    Last name:
    Name known by:
    Male or Female?
    Birthday (MM/DD/YYYY):
    Phone:
    E-mail:
    School/College:
    Grade:
    Religion:
    Sacraments Received: Dates if available (for parish database)

    If you have additional children, please fill out the form again, repeating the adults and starting with child 7 as child 1.

    Notes (optional)

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