Parish Registration Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address/Dirección REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email Please enter an email address.

¿Le gustaría recibir sobres para la Colecta Dominical?

Would you like to receive Sunday Collection envelopes? Yes/Sí No

How Many Family Members are you Registering?
¿Cuántos Miembros son en la Familia?

Family Members/Número de Miembros en la Familia REQUIRED Please fill out this field.

Family Members 1

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Relationship/Relación REQUIRED Please fill out this field. Please enter valid data.
Sacraments Received / Sacramentos Recibidos
Baptism/Bautismo Yes/Sí No
First Communion/Primera Comunión Yes/Sí No
Confirmation/Confirmación Yes/Sí No
Marriage/Matrimonio Yes/Sí No
None/Ninguno *

Thank You!