Step 1 of 3 33% Family InformationMailing Name* First Last Head of Household or FamilyMailing Address* Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secondary Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Email* Primary Phone*Number of Dependents In Household*Ok to print in Parish Publications*Check means it is ok to print field in Parish Publications Phone Address Email None Family InformationHead of Household Name* First Middle Last Maiden (If Applicable) Goes by Name (If Applicable) Sex* Male Female Email* Phone*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Marital Status* Single Married Divorced Widowed Married by Priest/Deacon* Yes No Date of Wedding*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Place of Wedding* Please include Church Name and City/StateReligious Affiliation* Baptized* Yes No Place of Baptism* Please Include Name of Church and City/StateSacraments/Activities Received* Reconcilation First Communion Confirmation RCIA None High School Attended* College Attended Occupation* Place of Employment* Any Special Concerns (Physical or developmental needs; languages other than English spoken, etc.)Spouse InformationSpouse Name* First Middle Last Maiden (If Applicable) Goes by Name (If Applicable) Sex* Male Female Email* Phone*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Religious Affiliation* Baptized* Yes No Place of Baptism* Please Include Name of Church and City/StateSacraments/Activities Received* Reconcilation First Communion Confirmation RCIA None High School Attended* College Attended Occupation* Place of Employment* Any Special Concerns (Physical or developmental needs; languages other than English spoken, etc.) Dependent #1 InformationName* First Middle Last Goes By Sex* Male Female Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Relationship* Grade School Grade (if currently attending)Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNoneHigh School Attended* College Attended Religious Affiliation* Baptized* Yes No Place of Baptism* Please Include Name of Church and City/StateSacraments/Activities Received* Reconcilation First Communion Confirmation RCIA None Occupation* Place of Employment* Any Special Concerns (Physical or developmental needs; languages other than English spoken, etc.)Dependent #2 InformationName* First Middle Last Goes By Sex* Male Female Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Relationship* Grade School Grade (if currently attending)Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNoneHigh School Attended* College Attended Religious Affiliation* Baptized* Yes No Place of Baptism* Please Include Name of Church and City/StateSacraments/Activities Received* Reconcilation First Communion Confirmation RCIA None Occupation* Place of Employment* Any Special Concerns (Physical or developmental needs; languages other than English spoken, etc.)Dependent #3 InformationName* First Middle Last Goes By Sex* Male Female Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Relationship* Grade School Grade (if currently attending)Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNoneHigh School Attended* College Attended Religious Affiliation* Baptized* Yes No Place of Baptism* Please Include Name of Church and City/StateSacraments/Activities Received* Reconcilation First Communion Confirmation RCIA None Occupation* Place of Employment* Any Special Concerns (Physical or developmental needs; languages other than English spoken, etc.)Additional DependentsIf you have more than three dependents please download the parish registration form and upload it in the Upload field You only need to fill out the dependent sectionsRegistration UploadAccepted file types: doc, dpf, docx, Max. file size: 15 MB. Additional InformationAdditional InformationCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
