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Around the Diocese
New Parishioner Registration
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Last Name
*
Phone (to be shown in Parish Directory)
*
Address
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Title
Mr.
Mrs.
Ms.
Dr.
Miss
Head of Household First Name
*
Head of Household Last Name
*
Head of Household Gender
*
Male
Female
Head of Household Date of Birth
*
Head of Household Mobile Number
*
Head of Household Email
*
Head of Household Occupation
*
Head of Household Employer
*
Head of Household is Catholic
Yes
No
Head of Household has received the following sacraments
*
Baptism
First Eucharist
Confirmation
Marriage
None
Marriage in Catholic church or convalidated?
Yes
No
Would you like more information about convalidation?
Yes
No
Spouse or Other Adult in Household Title
Mr.
Mrs.
Ms.
Dr.
Miss
Spouse or Other Adult in Household First Name
*
Spouse or Other Adult in Household Last Name
*
Spouse or Other Adult in Household Gender
*
Male
Female
Spouse or Other Adult in Household Date of Birth
*
Spouse or Other Adult in Household Mobile Number
*
Spouse or Other Adult in Household Email
*
Spouse or Other Adult in Household Occupation
Spouse or Other Adult in Household Employer
Spouse or Other Adult in Household Catholic
*
Yes
No
Spouse or Other Adult in Household has received the following sacraments
*
Baptism
First Eucharist
Confirmation
Marriage
None
Marriage in Catholic Church or convalidated?
*
Yes
No
Would you like more information about convalidation??
Yes
No
I/We are moving from
*
Share a picture of those in your household
Drag & Drop Files,
Choose Files to Upload
Uploaded picture may be used in the following
*
Realm/Connect
Parish Directory
Parish Website
Parish Social Media
Parish Videos (Finance and/or Stewardship)
Do not use picture
Level picture Would
Additional information/interests/comments
*
Complete the following for children living at home.
Space is provided for 4 children. If you need more space, please add the information in the text box at the end of the form. Thank you.
Child 1 Name
First
Last
Child 1 Date of Birth
Child 1 Gender
Male
Female
Child 1 Catholic Sacraments Received
Baptism
First Eucharist
Confirmation
Child 1 Current School Level
*
Not school aged
Preschool
Elementary K-5
Middle 6-8
High School 9-12
College/University
Out of high school or college and not enrolled in school
Child 1 Name of School
Child 2 Name
First
Last
Child 2 Date of Birth
Child 2 Gender
Male
Female
Child 2 Catholic Sacraments Received
Baptism
First Eucharist
Confirmation
Child 2 Current School Level
*
Not school aged
Preschool
Elementary K-5
Middle 6-8
High School 9-12
College/University
Out of high school or college and not enrolled in school
Child 2 Name of School
Child 3 Name
First
Last
Child 3 Date of Birth
Child 3 Gender
Male
Female
Child 3 Catholic Sacraments Received
Baptism
First Eucharist
Confirmation
Child 3 Current School Level
*
Not school aged
Preschool
Elementary K-5
Middle 6-8
High School 9-12
College/University
Out of high school or college and not enrolled in school
Child 3 Name of School
Child 4 Name
First
Last
Child 4 Date of Birth
Child 4 Gender
Male
Female
Child 4 Catholic Sacraments Received
Baptism
First Eucharist
Confirmation
Child 4 Current School Level
*
Not school aged
Preschool
Elementary K-5
Middle 6-8
High School 9-12
College/University
Out of high school or college and not enrolled in school
Child 4 Name of School
Additional Children — please list name, DOB, Gender, Catholic Sacraments Received, and school level and name
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