Registration Form

First Name:
Last Name:
Middle Name:
Email Address:
Mailing Address:
City: State: Zip Code:
Physical Address:
City: State: Zip Code:
Cell Phone:
Home Phone:
Work Phone:
Would you Like to Use Offertory Envelopes:
Seasonal Resident?
If Yes, when are you usually with us?
Family Member Names and Information:
Name Gender Role Birthdate Language Phone #/Other Info
Any Special Needs of any kind:
Check the Parish Involvement you or a Family Member might wish to participate:
Lector Knights of Columbus
Greeter Altar & Rosary
Usher Marriage Prep
Eucharistic Minister Religious Ed
Altar Server Sing with the Choir
Musical Instrument of any sort
Any Other Notes: