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Parish Registration Basic InformationLast Name* Mailing 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 Physical 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 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Phone*Cell PhoneEmail Address* Your InformationName* First Last Marital Status*SingleMarriedDivorcedWidowedDate of Marriage* MM slash DD slash YYYY Religion* Any Personal Disability?* Yes No Language(s) Spoken Occupation Place of Employment Sex* Male Female Date of Birth* MM slash DD slash YYYY Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No Emergency Contact InformationName* First Last Relationship to you?* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*What ministries are you interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Spouse InformationName* First Last Religion* Any Personal Disability?* Yes No Language(s) Spoken Occupation Place of Employment Sex* Male Female Date of Birth* MM slash DD slash YYYY Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Children InformationHow many children do you have in your household?* None 1 2 3 4 5 6 Child 1Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Any disabilities?* Yes No What disabilities and how can we help?*School and Grade* Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Child 2Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Any disabilities?* Yes No What disabilities and how can we help?*School and Grade* Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Child 3Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Any disabilities?* Yes No What disabilities and how can we help?*School and Grade* Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Child 4Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Any disabilities?* Yes No What disabilities and how can we help?*School and Grade* Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Child 5Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY 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? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Child 6Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Any disabilities?* Yes No What disabilities and how can we help?*School and Grade* Baptized?* Yes No First Communion?* Yes No First Reconciliation?* Yes No Confirmation?* Yes No What ministries are they interested in? Altar Server Eucharistic minister Lector Hospitality Minister Music Ministry Homebound Ministry Bereavement Ministry Adult Religious Education Elementary Religious Education Junior/Senior High School Religious Education Teen Youth Group St. Vincent de Paul Thrift Store Widow/Widowers Group Council of Catholic Women Knights of Columbus Additional InformationWill you use envelopes?* Yes No Is there any additional information that we may need to know?