Register

Basic Information

Last Name*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Physical Address*

Street Address Address Line 2 City State ZIP Code

Are you a seasonal or permanent resident?*

Seasonal
Permanent

What is your northern address?*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone

Email Address*

Your Information

Name*

First Last

Marital Status*

Date of Marriage*

Religion*

Any Personal Disability?*

Yes
No

Language(s) Spoken

Occupation

Place of Employment

Gender*

Male
Female

Date of Birth*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

Emergency Contact Information

Name*

First Last

Relationship to you?*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

What ministries are you interested in?

Spouse Information

Name*

First Last

Religion*

Any Personal Disability?*

Yes
No

Language(s) Spoken

Occupation

Place of Employment

Gender*

Male
Female

Date of Birth*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Children Information

How many children do you have in your household?*

Child 1

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Child 2

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Child 3

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Child 4

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Child 5

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Child 6

Name

First Last

Gender*

Male
Female

Date of Birth*

Any disabilities?*

Yes
No

What disabilities and how can we help?*

School and Grade*

Baptized?*

Yes
No

First Communion?*

Yes
No

First Penance?*

Yes
No

Confirmation?*

Yes
No

What ministries are they interested in?

Additional Information

Will you use envelopes?*

Yes
No

Is there any additional information that we may need to know?

	March 2020
Mon	Tue	Wed	Thu	Fri	Sat	Sun
						1
2	3	4	5 OA Thursday-ch title] March 5, 2020 @ 10:00 am - 11:00 am See more details •	6	7	8
9	10	11	12 OA Thursday-ch title] March 12, 2020 @ 10:00 am - 11:00 am See more details •	13	14	15
16	17	18 Stay Connected with myParish App title] March 18, 2020 @ 1:00 pm - 1:45 pm https://zoom.us/w/484304310?tk=-5xs4z1zUc2duKUNKxcXfBjW4uwxzO0GReZO1WDwjVE.DQEAAAAAHN3lthYxMmNWUDI4TFRidWVpWnJtMTRSazBnAA&uuid=WN_iim6wHZiSgGjspM1ue0aCw Join from a PC, Mac, iPad, iPhone or Android device: Please click this URL to join. https://zoom.us/w/484304310?tk=-5xs4z1zUc2duKUNKxcXfBjW4uwxzO0GReZO1WDwjVE.DQEAAAAAHN3lthYxMmNWUDI4TFRidWVpWnJtMTRSazBnAA&uuid=WN_iim6wHZiSgGjspM1ue0aCw Description: Diocesan is hosting webinars on using myParish App to help parishes connect people to the life of the parish when they can not be physically present. Join us to learn more. Or join by phone: Dial(for higher quality, dial a number based on your current location): US: +1 312 626 6799 or +1 929 436 2866 or +1 346 248 7799 or +1 669 900 6833 or +1 253 215 8782 or +1 301 715 8592 Webinar ID: 484 304 310 International numbers available: https://zoom.us/u/ay5lcGuKq See more details •	19 OA Thursday-ch title] March 19, 2020 @ 10:00 am - 11:00 am See more details •	20	21	22
23	24	25	26 OA Thursday-ch title] March 26, 2020 @ 10:00 am - 11:00 am See more details •	27	28	29
30	31

Parish Registration

Basic Information

Your Information

Emergency Contact Information

Spouse Information

Children Information

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Additional Information