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)

    Please type the letters you see so we can verify you are not a bot.
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    Mass & Reconciliation