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  • Today's/Registration Date REQUIRED Please fill out this field. Please enter a date.
  • FAMILY DETAILS
  • Mailing Details
    • Mailing Name: REQUIRED Maximum 35 characters

      The formal mailing name to address all parish mailings to.

      Please fill out this field. Please enter valid data.
    • Mailing Address: REQUIRED Please fill out this field. Please enter valid data.
    • City REQUIRED Please fill out this field. Please enter valid data.

      State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

      Zip REQUIRED Please fill out this field. Please enter a zip code.
    • Primary Phone: REQUIRED Maximum 20 characters

      12

      Please fill out this field. Please enter a phone number.
    • Phone is: REQUIRED Cell Home Please fill out this field.
    • Family Email: REQUIRED Maximum 35 characters Please fill out this field. Please enter an email address.
  • Previously registered? REQUIRED

    On your own or as a child under parents.

    No Yes Please fill out this field.
  • If yes, what years? Please enter valid data.
  • Special needs within household: Please enter valid data.
  • Have a representative from all ministries checked contact me: Adult Choir Altar Servers (4th gr and up) Catechist Childrens Choir Eucharistic Minister Holy Name Society Lector St. Joseph's Guild/Altar Society Usher Youth Ministry (6th-8th gr) Young Woman's Bible Study (ages 18-28)
  • FAMILY MEMBER DETAILS
  • • Number of Family Members: Please fill out this field.
    • ALL family within your household are added below. 1
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 2
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 3
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 4
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 5
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 6
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 7
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 8
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 9
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
    • ALL family within your household are added below. 10
      • Role REQUIRED Head of Family/Household: Spouse Daughter Son Partner Stepchild Parent Grandparent Other adult living in home Please fill out this field.
      • Gender REQUIRED (Select One) Female Male Please fill out this field.
      • Title Maximum 4 characters Please enter valid data.
      • First Name: REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
      • Middle Initial: Maximum 2 characters Please enter valid data.
      • Last Name: REQUIRED Please fill out this field. Please enter valid data.
      • Maiden Name: Please enter valid data.
      • Birthdate

        Providing this date help us with demographic reporting.

        Please enter a date.
      • Marital Status: REQUIRED (Select One) Single Married Divorced Annulled Separated Widow(er) Please fill out this field.
      • Date of Marriage, required if married Please enter a date.
      • Language REQUIRED (Select One) English Hispanic/Latino Tagalong Chinese Other Language not listed Not disclosed Please fill out this field.
      • Birthplace: Maximum 35 characters Please enter valid data.
      • Religion: REQUIRED (Select One) Catholic Dutch Reformed Jewish Lutheran Muslim Orthodox Other Christian Denomination Other Protestant Denomination Not practicing any religion Please fill out this field.
      • Ethnicity: REQUIRED (Select One) White/Caucasian American Indian/Alaska Native Asian/Pacific Islander Black/African American Filipino Hispanic/Latino Korean Other, not listed Not disclosed Please fill out this field.
      • Email: REQUIRED Please fill out this field. Please enter an email address.
      • Occupation: Please enter valid data.
      • Sacraments received w/in Catholic Church

        Please check all that apply

        Baptism First Penance/Reconciliation First Holy Communion Confirmation Sacrament of Marriage
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