Parish Registration Parish Registration 1Family Information2Ministry Interest Today's Date* MM slash DD slash YYYY Family InformationFamily Name*Spouse's Maiden NameHome Phone*Cell PhoneAlternate PhoneAddress* Street Address Address Line 2 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 ZIP Code Email Address* Alternate Email Address Head of HouseholdHead of Household Name* First Last Male/Female* Male Female Birth Date* MM slash DD slash YYYY Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Married* Yes No Catholic Marriage* Yes No Occupation*SpouseSpouse Name* First Last Maiden Name (if applicable) Male/Female* Male Female Birth Date* MM slash DD slash YYYY Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Catholic Marriage* Yes No Occupation*ChildrenHow many children are in the household?012345First ChildChild's Name* First Last Male/Female* Male Female Birth Date* MM slash DD slash YYYY Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Religious Education Level*Type of School Currently Attending* Public School Catholic School Home School Name of School*Second ChildChild's Name* First Last Male/Female* Male Female Birth Date* MM slash DD slash YYYY Birth Date* MM slash DD slash YYYY Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Religious Education Level*Type of School Currently Attending* Public School Catholic School Home School Name of School*Third ChildChild's Name* First Last Male/Female* Male Female Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Religious Education Level*Type of School Currently Attending* Public School Catholic School Home School Name of School*Fourth ChildChild's Name* First Last Male/Female* Male Female Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Religious Education Level*Type of School Currently Attending* Public School Catholic School Home School Name of School*Fifth ChildChild's Name* First Last Male/Female* Male Female Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Religious Education Level*Type of School Currently Attending* Public School Catholic School Home School Name of School*Others in HouseholdAre there any other adults that currently reside in your household?* No Yes, 1 Yes, 2 First Other AdultAdult's Name* First Last Male/Female* Male Female Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Relationship to Head of Household*Second Other AdultAdult's Name* First Last Male/Female* Male Female Religious Denomination* Catholic Baptism* Yes No Eucharist* Yes No Confirmation* Yes No Relationship to Head of Household* Ministries/Interests Greeter Lector Usher Altar Server Choir/Cantor Eucharistic Minister Sacristan Church Art & Environment Crafts Church Cleaning Altar Linens Cooking/Baking Funeral Luncheons Gardening/Weeding Carpentry Electrician General Maintenance Computer/Technology Photography/Video Adult Faith Formation Youth Ministry Catechist Other What other ministry do your have in mind?*EmailThis field is for validation purposes and should be left unchanged.
