New Parishioner Registration Form Registration FormAdditional InformationReviewRegistration FormRequiredToday's Date:*RequiredFamily Name:*RequiredMale: <Select> Mr. Dr. *RequiredMale (last, first, middle initial):*RequiredFemale: <Select> Mrs. Miss Ms. Dr. *RequiredFemale (last, first, maiden name)*RequiredAddress:*RequiredCity:*RequiredState:*RequiredZip Code:*RequiredPlease enter a valid email address with the format youraddress@yourdomain.Email*RequiredHome Phone:*May we list the following in our parish directory?*RequiredEmail(s): Yes No *RequiredCell Phone Number(s): Yes No *RequiredI/We have just moved from (Parish Name, City, State):*RequiredPlease enter a date with the format D/M/YYYY.Today's Date:*RequiredChurch Attendance: Weekly Occasionally Seldom *Husband or Single AdultRequiredFull Name:*RequiredNickname:*RequiredEmail Address:*RequiredReligion:*RequiredOccupation:*RequiredName of Employer:*RequiredCell Phone:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism: *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: *Wife:RequiredFull Name:*RequiredNickname:*RequiredPlease enter a valid email address with the format youraddress@yourdomain.Email Address:*RequiredReligion:*RequiredOccupation:*RequiredName of Employer:*RequiredCell Phone:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism: *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: *Number of ChildrenRequiredNumber of Children: 0 1 2 3 4 *Child 1:RequiredFull Name:*RequiredNickname:*RequiredReligion:*RequiredOccupation:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism: *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: *Child 2:RequiredFull Name:*RequiredNickname:*RequiredReligion:*RequiredOccupation:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism? *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: *Child 3:RequiredFull Name:*RequiredNickname:*RequiredReligion:*RequiredOccupation:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism: *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: *Child 4:RequiredFull Name:*RequiredNickname:*RequiredReligion:*RequiredOccupation:*RequiredBirth Date:*RequiredBaptized? Yes No *RequiredPlace and Date of Baptism: *RequiredFirst Communion? Yes No *RequiredPlace and Date of First Communion: *RequiredConfirmed? Yes No *RequiredPlace and Date of Confirmation: * Â Â
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