Section 1: Required Information

Salutation (required)

—Please choose an option—Mr.Mrs.Ms.Dr.

First Name (required)

Last Name (required)

Email (required)

Phone Number (required)

Street Address (required)

City (required)

State (required)

—Please choose an option—ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip Code (required)

Section 2: Adult Information

Are you married?

YesNo

Were you married in a Catholic church, in a civil service, or in another denominational church?

CatholicCivilOther

Date of Marriage

Church/Place of Marriage

If you are married, please fill out both the "Husband" and "Wife" sections. If you are single, please fill out one of the sections. You may leave the other section blank.

Husband

First Name

Last Name

Date of Birth

Religion

Which Sacraments have you received within the Catholic Church?

BaptismFirst Holy CommunionConfirmation

Wife

First Name

Last Name

Date of Birth

Religion

Which Sacraments have you received within the Catholic Church?

BaptismFirst Holy CommunionConfirmation

Section 3: Children Information

If you have children in your household, please fill out the following section. Adult children need not be listed. If you do not have children in your household, skip ahead to Section 4.

Name(s)

Date(s) of Birth

Grade(s) / School(s) if Applicable

Is/are your child(ren) Baptized?

Did your child(ren) receive First Holy Communion?

Is/are your child(ren) Confirmed?

Section 4: Parish Involvement

Would you be interested in any of these ministries in our parish?

Adult ChoirChildren's Choir (Grade 3+)Folk GroupAltar Servers (Grade 5+)BaptismBible StudyEucharistic MinistersLectorsLeisure ClubLegion of MaryKnights of ColumbusNetwork of CarePre-CanaReligious Education Program (Grade 1-8)RCIA (age 14+)UshersYouth GroupEnglish Conversation Class

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