bool(false) New Parishioner Registration Home / New Parishioner Registration "*" indicates required fields FacebookThis field is for validation purposes and should be left unchanged.Today's Date* MM slash DD slash YYYY Household InformationAddress*Address Line 2City*Zip Code*Primary Phone Number*Primary EmailFirst AdultName* First Middle Last Nickname & Maiden Name Nickname Maiden Name Choose One:MaleFemaleChoose One:Mr.Mrs.MissMs.Date of Birth Month Day Year Education LevelNo formal educationSome high schoolHigh school diploma or equivalentSome collegeAssociate's degreeBachelor's degreeMaster's degreeDoctorate or professional degreeCell PhoneEmailOccupationEmployerWork PhoneReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Marital StatusChoose one:SingleEngagedMarriedWidowedSeparatedDivorcedMarried by Priest/Deacon?YesNoDate of Marriage Month Day Year Place/ChurchCelebrant NameCity/StateRegister another adult?NoYesSecond AdultName First Middle Last Nickname & Maiden Name Nickname Maiden Name Choose One:MaleFemaleChoose One:Mr.Mrs.MissMs.Date of Birth Month Day Year Education LevelNo formal educationSome high schoolHigh school diploma or equivalentSome collegeAssociate's degreeBachelor's degreeMaster's degreeDoctorate or professional degreeCell PhoneEmailOccupationEmployerWork PhoneReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Marital StatusChoose one:SingleEngagedMarriedWidowedSeparatedDivorcedMarried to:ChildrenDo you have children?NoYesFirst ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Add a second child?NoYesSecond ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Add a third child?NoYesThird ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Add a fourth child?NoYesFourth ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Add a fifth child?NoYesFifth ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Add a sixth child?NoYesSixth ChildName First Middle Last Nickname Nickname Choose One:MaleFemaleAgeDate of Birth Month Day Year SchoolGradeEmailReligion (if not Catholic)Please check each Sacrament received: Baptism Confirmation Reconciliation Eucharist Select AllDate of Baptism Month Day Year Date of Confirmation Month Day Year Date of First Reconciliation Month Day Year Date of First Eucharist Month Day Year Emergency ContactPlease include an emergency contact who is not listed on this form already.Name First Last RelationshipPhone NumberWelcome InformationWould you like a welcome visit?Yes, at the churchYes, at my homeNoWould you like to meet with our Sacramental Minister or Director of Parish Life?Yes, I'd like to meet with Fr. Rick Filary, Sacramental MinisterYes, I'd like to meet with John Graveline, Director of Parish LifeNoWhere would you like to pick up your welcome packet?At the parish officeAt churchMay we put your name(s) in the parish bulletin as a welcome to new members?YesNoMay we include your photo in a welcome message on the TV in the gathering space?YesNoPlease include a household photo.Max. file size: 200 MB. Are you registered at another parish?NoYesWhat parish?Do you wish to continue that membership?YesNoWhich parish is your primary parish?Would you like to receive envelopes?YesNoWould you like to learn more about Online Giving?YesNoWould you like to receive email and/or text updates?YesNoCommunication PreferenceEmailTextWhat kind of communications would you like to receive? Weekly Events & Announcements Daily Reflections from the “Little Books” (Advent/Christmas & Lent/Easter) Children’s Faith Formation (Age 3-Grade 5) Middle School Youth Ministry High School Youth Ministry CAPTCHA Δ
