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New Parishioner Registration

- Parish

The maximum number of form submissions has been reached. This form is currently not available.
- Please fill this form out in its entirety. If you have questions or need assistance, please contact the parish office.
- New Parishioner(s) REQUIRED Yes No Please fill out this field.
- Parish REQUIRED Please fill out this field.
- Heads of Household REQUIRED
  Head of Household and spouse, if applicable
  Please fill out this field.
  
  Parishioner 1
  
  Title REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Homebound? REQUIRED Yes No Please fill out this field.
  
  Nursing Home/Assisted Living REQUIRED Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status
  
  OPTIONAL: If you are in a civil marriage, would you like to discuss having your marriage convalidated? Yes No
  
  Contact Information
  
  Occupation 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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sacraments
  
  Denomination REQUIRED Catholic Non-Catholic Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation Marriage Please fill out this field.
  
  If you have not completed sacraments, or are not Catholic, would you be interested in an adult education program? REQUIRED Yes No Not applicable Please fill out this field.
  
  Ministry
  
  Indicate which ministries you would like to help with or are currently volunteering for: REQUIRED
  Training will be provided
  None Lector/Reader - Daily Lector/Reader - Weekend Sacristan Extraordinary Minister of Holy Communion Usher Collection Counter (Mondays) Music - Vocals Music - Pianist Please fill out this field.
  
  Preferred Weekend to Volunteer (Check all that apply) REQUIRED 1st Weekend 2nd Weekend 3rd Weekend 4th & 5th Weekend Substitute Not applicable Please fill out this field.
  
  Is there another parishioner you typically volunteer with? Please enter valid data.
  
  Other Ministry Opportunities REQUIRED None Eucharistic Adoration Knights of Columbus Confraternity of Christian Mothers Catholic Daughters of the Americas Funeral Meals Sick & Homebound Ministry Mother's Ministry Faith Formation Aide Faith Formation Teacher Prayer Chain Please fill out this field.
  
  Do you have any special skills you would be willing to use to help the parish? Please enter valid data.
  
  Parishioner 2
  
  Title REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Homebound? REQUIRED Yes No Please fill out this field.
  
  Nursing Home/Assisted Living REQUIRED Yes No Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status
  
  OPTIONAL: If you are in a civil marriage, would you like to discuss having your marriage convalidated? Yes No
  
  Contact Information
  
  Occupation 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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Sacraments
  
  Denomination REQUIRED Catholic Non-Catholic Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation Marriage Please fill out this field.
  
  If you have not completed sacraments, or are not Catholic, would you be interested in an adult education program? REQUIRED Yes No Not applicable Please fill out this field.
  
  Ministry
  
  Indicate which ministries you would like to help with or are currently volunteering for: REQUIRED
  Training will be provided
  None Lector/Reader - Daily Lector/Reader - Weekend Sacristan Extraordinary Minister of Holy Communion Usher Collection Counter (Mondays) Music - Vocals Music - Pianist Please fill out this field.
  
  Preferred Weekend to Volunteer (Check all that apply) REQUIRED 1st Weekend 2nd Weekend 3rd Weekend 4th & 5th Weekend Substitute Not applicable Please fill out this field.
  
  Is there another parishioner you typically volunteer with? Please enter valid data.
  
  Other Ministry Opportunities REQUIRED None Eucharistic Adoration Knights of Columbus Confraternity of Christian Mothers Catholic Daughters of the Americas Funeral Meals Sick & Homebound Ministry Mother's Ministry Faith Formation Aide Faith Formation Teacher Prayer Chain Please fill out this field.
  
  Do you have any special skills you would be willing to use to help the parish? Please enter valid data.
- Children
- Defined as children, under the age of 21, living in your home and/or in college.
  
  Adult children over the age of 21 should be registered as their own household.
- Dependent Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 5
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 6
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 7
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 8
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 9
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 10
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 11
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
  
  Child 12
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Grade
  
  School Please enter valid data.
  
  Altar Server Interested in serving
  
  Sacraments
  
  Baptism
  
  Parish Please enter valid data.
  
  First Communion
  
  Parish Please enter valid data.
  
  Confirmation
  
  Parish Please enter valid data.
- Household Information
  
  Previous Parish (if applicable) Please enter valid data.
  
  Preferred Mass Time REQUIRED Saturday, 4pm Sunday, 8am Sunday, 930am Sunday, 11am St. Mary or St. Philomena Please fill out this field.
- Generosity
  
  Would you like to receive giving envelopes? REQUIRED Yes No Please fill out this field.
  
  Would you like to enroll in automatic withdrawal or online giving? REQUIRED Yes No Please fill out this field.
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