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Parish Registration

- Communications & Media

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- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
- State REQUIRED Please fill out this field. Please enter valid data.
- Zip Code REQUIRED Please fill out this field. Please enter valid data.
- Home / Cell Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email Please enter valid data.
- Please select the number of family members that are in your family that you wish to register in the option below. This will add additional spaces for more members at the end of this form, if necessary.
- Number of Additional Family Members REQUIRED Please fill out this field.
  
  Family Member 1
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 2
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 3
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 4
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 5
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 6
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 7
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 8
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 9
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 10
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 11
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
  
  Family Member 12
  
  Family Member Last Name, First Name, Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Family Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters
  (If Different Than the Phone Number Entered Above)
  Please enter a phone number.
  
  Mailing List REQUIRED
  Would this person like to be on the parish mailing list?
  Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Baptized? Yes No
  
  Baptized At: (Church Name and Location) Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Received First Communion? Yes No
  
  Date of First Communion Please enter a date.
  
  Confirmed? Yes No
  
  Date of Confirmation Please enter a date.
  
  Marital Status
  
  Date of Marriage (if applicable) Please enter a date.
  
  Married by a Priest? (if applicable) Yes No
  
  Maiden Name (if applicable) Please enter valid data.
  
  Denomination
  
  Converted to the Catholic Faith? Yes No
  
  Housebound? (Shut In) Yes No
  
  Request Home Visit Yes No
  
  Location of Home Visit Please enter valid data.
  
  Receiving Communion? Yes No
  
  Name of School Attending / Last School Attended Please enter valid data.
  
  Level of Education
  
  Church Attendance
- Thank you again for your interest in St. Mary's Catholic Church. We are grateful for your interest in our parish, and we hope to meet you soon. God Bless!
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