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New Parishioner Registration

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  Head of Household Information
  
  Prefix
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Apartment, Suite, etc. 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Business Phone Number Maximum 20 characters Please enter a phone number.
  
  Date of Birth Please enter a date.
  
  Occupation Please enter valid data.
  
  Marital Status Please enter valid data.
  
  Marriage Date Please enter a date.
  
  Catholic Marriage? Yes No
  
  Are you Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Confirmed? Yes No
  
  Catholic Baptism? Yes No
  
  Spouse's Information
  
  Prefix
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Apartment, Suite, etc. 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Business Phone Number Maximum 20 characters Please enter a phone number.
  
  Date of Birth Please enter a date.
  
  Occupation Please enter valid data.
  
  Marital Status Please enter valid data.
  
  Marriage Date Please enter a date.
  
  Catholic Marriage? Yes No
  
  Are you Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Confirmed? Yes No
  
  Catholic Baptism? Yes No
  
  Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 2
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 3
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 4
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 5
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 6
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 7
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 8
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 9
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  Child 10
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Grade Please enter valid data.
  
  Catholic? Yes No
  
  If you answered no, what religion? Please enter valid data.
  
  Catholic Baptism? Yes No
  
  First Communion? Yes No
  
  Confirmed? Yes No
  
  Enrolled in R.E. classes? Yes No
  
  Enrolled in Rosary School? Yes No
  
  If there is any additional information you would like to add, such as any additional children, please do so here.
  
  Submit
  
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