Parish Registration

Thanks for taking a moment to send your household's request to our parish's office. Please fill out the form as completely as possible then click submit.

Family Information
Where do you plan on attending Mass?
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Home Address
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Primary Phone --
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Secondary Phone --
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Email Address
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Alternative Email Address
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Other Preferred Means of Communication? Please list here.
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Check all that apply
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Do you want to receive contribution envelopes?
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Member #1
Full Name
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Preferred Nickname
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Maiden Name if applicable
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Role in Household
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 Husband, wife, son, daughter, etc
Gender
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Date of Birth //
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Birth Place
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Sacraments Completed
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 Check all that apply
Date of Baptism  
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Location of Baptism
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 Church name and location if known
Date of 1st Reconciliation  
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Location of 1st Reconciliation
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 Church name and location if known
Date of 1st Communion  
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Location of 1st Communion
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 Church name and location if known
Date of Confirmation  
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Location of Confirmation
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 Church name and location if known
Date of Marriage (if applicable) //
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Location of Marriage
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 Church name and location if known
Member #2
Full Name
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Preferred Nickname
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Maiden Name if applicable
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Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
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Date of Birth //
  •  
Birth Place
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Sacraments Completed
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Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
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Location of Marriage
  •  
 Church name and location if known
Member #3
Full Name
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Preferred Nickname
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Maiden Name if applicable
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Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
  •  
Date of Birth //
  •  
Birth Place
  •  
Sacraments Completed
  •  
Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
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Location of Marriage
  •  
 Church name and location if known
Member #4
Full Name
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Preferred Nickname
  •  
Maiden Name if applicable
  •  
Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
  •  
Date of Birth //
  •  
Birth Place
  •  
Sacraments Completed
  •  
Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
  •  
Location of Marriage
  •  
 Church name and location if known
Member #5
Full Name
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Preferred Nickname
  •  
Maiden Name if applicable
  •  
Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
  •  
Date of Birth //
  •  
Birth Place
  •  
Sacraments Completed
  •  
Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
  •  
Location of Marriage
  •  
 Church name and location if known
Member #6
Full Name
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Preferred Nickname
  •  
Maiden Name if applicable
  •  
Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
  •  
Date of Birth //
  •  
Birth Place
  •  
Sacraments Completed
  •  
Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
  •  
Location of Marriage
  •  
 Church name and location if known
Member #7
Full Name
  •  
Preferred Nickname
  •  
Maiden Name if applicable
  •  
Role in Household
  •  
 husband, wife, son, daughter, etc
Gender
  •  
Date of Birth //
  •  
Birth Place
  •  
Sacraments Completed
  •  
Date of Confirmation  
  •  
Date of Baptism  
  •  
Location of Baptism
  •  
 Church name and location if known
Date of 1st Reconciliation  
  •  
Location of 1st Reconciliation
  •  
 Church name and location if known
Date of 1st Communion  
  •  
Location of 1st Communion
  •  
 Church name and location if known
Date of Confirmation  
  •  
Location of Confirmation
  •  
 Church name and location if known
Date of Marriage (if applicable) //
  •  
Location of Marriage
  •  
 Church name and location if known
Message If you have more than seven members in your home, please call the office and we will input them into our system. Thank you!
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