New Parishioner Registration

Thanks for notifying the parish office of your wish to register. Please fill out the form as completely as possible and then click submit. A staff member will contact you about registering with the parish.

Name of Husband

First Name

Last Name

Name of Wife

First Name

Last Name

First and Last Name(s) of Other Adult(s) in Household

First and Last Names of Child(ren) in Household

Primary Phone

Required* --

Secondary Phone

Email Address

Required*

Alternative Email Address

Home Address

Street 1

Street 2

City

State

Zip

Other Preferred Means of Communication? Please list here.

Is this information:
Required*

	Brand New Information?
	An Update to a Current Household Listing?

Can we publish your name in the Bulletin?
Required*

	No
	Yes

New Parishioner Registration

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