Parish Registration Form Home / Parish Registration Form Parish Registration Registration Date: MM slash DD slash YYYY Family LAST NAME:*Telephone Number:*Home 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 Mailing Address (if different): 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 Email Address:* How do you wish to take care of your financial responsibility to St. Helen Church:* Yearly Monthly Weekly Envelopes Online Giving Member InformationMember Name (LAST, FIRST):*Maiden Name:Nickname:Title (check if used): Mr. Mrs. Ms. Miss Dr. Suffix (check if used): Sr. Jr. II III IV Esq. Date of Birth:*Gender:*Highest Grade/Degree:*Ethnic Background:*Language:*Occupation, Location, Business Phone #:Marital Status:* Single Married Widow(er) Separated Divorced Religion* Catholic Non-Catholic Sacraments:Baptized Catholic:* Yes No Baptism Date & Location (Parish, City, State) (to the best of your knowledge):First Holy Communion* Yes No First Holy Communion Date & Location (Parish, City, State) (to the best of your knowledge):First Penance/Reconciliation: Yes No First Penance/Reconciliation Date & Location (Parish, City, State) (to the best of your knowledge):Confirmation:* Yes No Confirmation Date & Location (Parish, City, State) (to the best of your knowledge):Married:* Yes No Marriage Date & Location (Parish, City, State) (to the best of your knowledge):Married by a Priest:* Yes No Member Information (2)Member Name (LAST, FIRST):Maiden Name:Nickname:Title (check if used): Mr. Mrs. Ms. Miss Dr. Suffix (check if used): Sr. Jr. II III IV Esq. Date of Birth:Gender:Highest Grade/Degree:Ethnic Background:Language:Occupation, Location, Business Phone #:Marital Status: Single Married Widow(er) Separated Divorced Religion Catholic Non-Catholic Sacraments:Baptized Catholic: Yes No Baptism Date & Location (Parish, City, State) (to the best of your knowledge):First Holy Communion Yes No First Holy Communion Date & Location (Parish, City, State) (to the best of your knowledge):First Penance/Reconciliation: Yes No First Penance/Reconciliation Date & Location (Parish, City, State) (to the best of your knowledge):Confirmation: Yes No Confirmation Date & Location (Parish, City, State) (to the best of your knowledge):Married: Yes No Marriage Date & Location (Parish, City, State) (to the best of your knowledge):Married by a Priest: Yes No Add a child? Yes ChildrenName (LAST, FIRST):Date of Birth:Baptized Catholic: Yes No Baptism Date & Location (Parish, City, State):First Penance/Reconciliation: Yes No First Penance/Reconciliation Date & Location (Parish, City, State) (to the best of your knowledge):First Holy Communion: Yes No First Holy Communion Date & Location (Parish, City, State) (to the best of your knowledge):Confirmation: Yes No Confirmation Date & Location (Parish, City, State) (to the best of your knowledge):Add another child? Yes Child (2)Name (LAST, FIRST):Date of Birth:Baptized Catholic: Yes No Baptism Date & Location (Parish, City, State):First Penance/Reconciliation: Yes No First Penance/Reconciliation Date & Location (Parish, City, State) (to the best of your knowledge):First Holy Communion: Yes No First Holy Communion Date & Location (Parish, City, State) (to the best of your knowledge):Confirmation: Yes No Confirmation Date & Location (Parish, City, State) (to the best of your knowledge):Add another child? Yes Child (3)Name (LAST, FIRST):Date of Birth:Baptized Catholic: Yes No Baptism Date & Location (Parish, City, State):First Penance/Reconciliation: Yes No First Penance/Reconciliation Date & Location (Parish, City, State) (to the best of your knowledge):First Holy Communion: Yes No First Holy Communion Date & Location (Parish, City, State) (to the best of your knowledge):Confirmation: Yes No Confirmation Date & Location (Parish, City, State) (to the best of your knowledge):CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
