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  • Family name REQUIRED

    Last name

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  • Registration date REQUIRED Please fill out this field. Please enter a date.
  • Street address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Primary phone number REQUIRED Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Prior parish REQUIRED Please fill out this field. Please enter valid data.
  • List primary phone in parish directory REQUIRED Yes No Please fill out this field.
  • • Number of head(s) of household REQUIRED Please fill out this field.
    • Head(s) of household 1
      • Last name and maiden name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Cell phone Please enter a phone number.
      • Work phone Please enter a phone number.
      • Occupation Please enter valid data.
      • Employer Please enter valid data.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received (check all that apply) Baptism First communion Confirmation None
      • Marital status REQUIRED Married Single Divorced Please fill out this field.
      • Date married Please enter a date.
      • Church where married Please enter valid data.
      • Interested in the following ministries/organizations Athletic association volunteer Bible study Choir Christ Renews His Parish Church cleaning Deck the Halls Bazaar Eucharistic Adoration Extraordinary minister of Holy Communion Family rosary Grounds maintenance Hospitality committee Knights of Columbus Lector Life in the spirit Marriage encounter Music Musician Parish picnic Prayer chain Parish school of religion volunteer Parent teacher's organization Resect life committee St Vincent de Paul Society School volunteer Vacation bible school volunteer
    • Head(s) of household 2
      • Last name and maiden name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Cell phone Please enter a phone number.
      • Work phone Please enter a phone number.
      • Occupation Please enter valid data.
      • Employer Please enter valid data.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received (check all that apply) Baptism First communion Confirmation None
      • Marital status REQUIRED Married Single Divorced Please fill out this field.
      • Date married Please enter a date.
      • Church where married Please enter valid data.
      • Interested in the following ministries/organizations Athletic association volunteer Bible study Choir Christ Renews His Parish Church cleaning Deck the Halls Bazaar Eucharistic Adoration Extraordinary minister of Holy Communion Family rosary Grounds maintenance Hospitality committee Knights of Columbus Lector Life in the spirit Marriage encounter Music Musician Parish picnic Prayer chain Parish school of religion volunteer Parent teacher's organization Resect life committee St Vincent de Paul Society School volunteer Vacation bible school volunteer
  • • Other family members REQUIRED Please fill out this field.
    • Other family members 1
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 2
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 3
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 4
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 5
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 6
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 7
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 8
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 9
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group
    • Other family members 10
      • Last name REQUIRED Please fill out this field. Please enter valid data.
      • First and middle name REQUIRED Please fill out this field. Please enter valid data.
      • Relation REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • Birth date REQUIRED Please fill out this field. Please enter a date.
      • Sacraments received REQUIRED Baptism Confirmation First communion None Please fill out this field.
      • School/employer REQUIRED Please fill out this field. Please enter valid data.
      • Grade REQUIRED Please fill out this field. Please enter an integer (number).
      • Interested in being contacted about the following parish ministries/organizations Altar server (5th grade or older) Athletics Choir Eucharistic adoration Extraordinary minister of the Eucharist Lector Music ministry Parish picnic Pasish school of religion volunteer School volunteer Vacation bible school volunteer Youth group

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