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New Members
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New Member Registration Form
New Member Registration Form
Welcome! We are eager to get to know you!
Step
1
of
4
- Head of Household
25%
Do we have your permission to include names in parish bulletin which is posted on our website?
(Required)
yes
no
Would you like to receive contribution envelopes?
(Required)
yes
no
Information for Head of Household or Single Parishioner
Family (Last) name
(Required)
Address
(Required)
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Illinois
Indiana
Iowa
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Louisiana
Maine
Maryland
Massachusetts
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Northern Mariana Islands
Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Head of Household - FIrst Name
(Required)
First
Middle & Maiden Name (if applicable)
Middle
Maiden name, if applicable
Goes by / nickname
Preferred title/suffix
(Required)
Mr. Mrs. Ms. Miss. Dr. Jr. Sr. Other
Date of birth (Month/date/year)
(Required)
Month
Month
1
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Day
Day
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1932
1931
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1928
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1926
1925
1924
1923
1922
1921
1920
Home/family phone
Type
(Required)
Home
Cell
Office
Preferred phone
Type
(Required)
Home
Cell
Office
Alternate phone
Type
Home
Cell
Office
Email address
(Required)
Preferred method of contact
Call
Text
Email
Occupation (optional)
Religion
If not catholic, do you wish to be listed on parish mailings?
Yes
No
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Spouse (items may be left blank if they are the same)
Spouse: (Last name, if different)
Name
First
Middle
Maiden name, if applicable
Goes by / nickname
Preferred title/suffix
Mr. Mrs. Ms. Miss. Dr. Jr. Sr. Other
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
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5
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Year
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2020
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1981
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1970
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1951
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1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Preferred phone
Type
Home
Cell
Office
Alternate phone
Type
Home
Cell
Office
Email address
Preferred method of contact
Call
Text
Email
Occupation (optional)
Religion
If not catholic, do you wish to be listed on parish mailings?
Yes
No
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Marital status
Married
Widowed
Divorced
Separated
Single
If married, date of marriage and parish (name and location)
Previous parish (name and location)
Children living at home
Include only children living at home or supported by the family (college students, etc.). Any other adults residing in your home should complete a separate registration form.
Child 1 Name
First
Middle
Last
Goes by / nickname
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
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31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
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1991
1990
1989
1988
1987
1986
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1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
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1959
1958
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1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
Male
Female
School
Grade
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Child 2 Name
First
Middle
Last
Goes by / nickname
Gender
Male
Female
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
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10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
School
Grade
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Child 3 Name
First
Middle
Last
Goes by / nickname
Gender
Male
Female
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
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1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Grade
School
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Child 4 Name
First
Middle
Last
Goes by / nickname
Gender
Male
Female
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Grade
School
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Child 5 Name
First
Middle
Last
Goes by / nickname
Gender
Male
Female
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Grade
School
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No
Child 6 Name
First
Middle
Last
Goes by / nickname
Gender
Male
Female
Date of birth (Month/date/year)
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Grade
School
Sacraments Received:
Baptism
Yes
No
Baptism Location
If yes, church and location
First Eucharist
Yes
No
Confirmation
Yes
No