Parish Registration Become a part of our parish family! 1Registration Information2Family Member Information3Ministry Interest Family InformationFormer Parish* Former Parish Address* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Family Last Name* Number of Family Members at Home*Address Mail To* Mr./Mrs. Mr. Mrs. Dr./Mrs. Mr./Dr. Miss Ms Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Phone*Cell*Email* Head of Household InformationHead of Household Name* First Last Date of Birth* Month Day Year Sex* Female Male Marital Status* Single Married Divorced Widowed Separated Maiden Name* Maiden Name Special Circumstances Confined to Home In Nursing Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Sacraments Received Baptism First Penance First Comunion Confirmation Marriage Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)Marriage Information*Date of MarriageChurchChurch Location (City, ST)Highest School Grade Attended or Highest Degree Attained* School Name(if enrolled)) Current Grade in School* Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Place of Employment Business Phone* I Would Like To* Add a Child Add Another Adult Move to the Next Section (no other family members) SpouseSpouse Name* First Last Date of Birth* Month Day Year Sex* Female Male Marital Status* Single Married Divorced Widowed Separated Maiden Name* Maiden Name Special Circumstances Confined to Home In Nursing Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Sacraments Received Baptism First Penance First Communion Confirmation Marriage Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)Highest School Grade Attended or Highest Degree Attained* School Name(if enrolled)) Current Grade in School* Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Place of Employment Business Phone* I Would Like To* Add a Child Add Another Adult Move to the Next Section (no other family members) Other AdultPlease remember to only add family members that currently live with you.Name* First Last Relation to Head of Household*Please let us know how this other adult is related to the head of household. Date of Birth* Month Day Year Sex* Female Male Marital Status* Single Married Divorced Widowed Separated Special Circumstances Confined to Home In Nursing Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Sacraments Received Baptism First Penance First Comunion Confirmation Marriage Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)Marriage Information*Date of MarriageChurchChurch Location (City, ST)Highest School Grade Attended or Highest Degree Attained* School Name(if enrolled)) Current Grade in School* Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Place of Employment Business Phone* I Would Like To* Add a Child Move to the Next Section (no other family members) Child 1 InformationName* First Last Date of Birth* Month Day Year Sex* Female Male Special Circumstances Confined to Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Currently enrolled in Faith Formation classes?* Yes No Sacraments Received Baptism First Penance First Comunion Confirmation Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)School Name(if enrolled)) Current Grade in School Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Student Student with a job Type of Occupation Place of Employment Business Phone I Would Like To* Add Another Child Move to the Next Section (no other family members) Child 2 InformationName* First Last Date of Birth* Month Day Year Sex* Female Male Special Circumstances Confined to Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Currently enrolled in Faith Formation classes?* Yes No Sacraments Received Baptism First Penance First Comunion Confirmation Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)School Name(if enrolled)) Current Grade in School Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Student Student with a job Type of Occupation Place of Employment Business Phone I Would Like To* Add Another Child Move to the Next Section (no other family members) Child 3 InformationName* First Last Date of Birth* Month Day Year Sex* Female Male Special Circumstances Confined to Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Currently enrolled in Faith Formation classes?* Yes No Sacraments Received Baptism First Penance First Comunion Confirmation Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)School Name(if enrolled)) Current Grade in School Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Student Student with a job Type of Occupation Place of Employment Business Phone I Would Like To* Add Another Child Move to the Next Section (no other family members) Child 4 InformationName* First Last Date of Birth* Month Day Year Sex* Female Male Special Circumstances Confined to Home Special Needs What are the special needs that we should be aware of?* Would this person like to be visited at home by our priest?* Yes No Religion* Catholic Are you interested in learning more about the Catholic Faith?* Yes No Number of Years Attended Faith Formation*Currently enrolled in Faith Formation classes?* Yes No Sacraments Received Baptism First Penance First Comunion Confirmation Baptism Information*Date of BaptismChurchChurch Location (City, ST)First Penance Information*Date of First PenanceChurchChurch Location (City, ST)First Communion Information*Date of First CommunionChurchChurch Location (City, ST)Confirmation Information*Date of ConfirmationChurchChurch Location (City, ST)School Name(if enrolled)) Current Grade in School Ethnic Group* White/Caucasian Hispanic Black/African American Native American Asian Primary Language Spoken* Other Languages Spoken Occupation Student Student with a job Type of Occupation Place of Employment Business Phone I Would Like To* Move to the Next Section (no other family members) Please let us know if you have more than 4 childrenIf you have more than 4 children, the parish office will contact you at a later date to receive the appropriate information from you. Yes, I have more than 4 children. Ministry InterestPlease select the ministries that you or someone in your household is interested in: Community Ministry/Outreach Faith Formation Evangelization/Communication Facilities Management Liturgy/Worship Parish Life Stewardship Are there any other ministries you are interested in that we have not listed?* No, I have selected all ministries I am interested in. Community Ministry/Outreach*Please select the following community ministry/outreach activities that you are most interested in helping with. Blood Drive (monthly) Christmas Angel Tree (annually) Crisis Ministry (monthly) Food Pantry (as needed) Holiday Food Baskets (holidays) Veterans (annually) Alpha Pregnancy (annually) Special Olympics (annually) Home/School (weekly) Quilters (as needed) Episcopal Luncheon (as needed) Empty Stocking (annually) ESL-English as a Second Language (weekly) Citizenship Classes (weekly) Faith Formation/Education*Please select the following faith formation/education activities that you are most interested in helping with. Adult Education Youth Ministry RCIA (Rite of Christian Initiation of Adults) Pre-Baptism (Baptism Preparation) Confirmation Sacraments of Reconciliation and Eucharist Liturgy/Worship*Please select the following liturgy/worship groups that you are most interested in helping with. Altar Care Altar Server Eucharistic Minister Greeter/Usher Lector Liturgical Commission Music Ministry/Chorus Sick/Homebound Parish Life*Please select the following parish life groups that you are most interested in helping with. Lady's Guild Knights of Columbus Senior Citizens
