CAPTCHAToday's date: MM slash DD slash YYYY Family InformationFamily Surname:* Address: City: State: Zip: Are you comfortable with a welcome in our parish bulletin? Yes No Member InformationName: First MI Last Birthdate: Maiden Name: Gender: Male Female Primary Phone: Cell Phone: Email: Sacraments received:Baptismal Status: Catholic Protestant Not Baptized Confirmed Catholic: Yes No Eucharist: Yes No Marriage Status: Single Catholic Marriage Other Marriage Widowed Divorced Additional information:Occupation: Place of Employment: Employer Phone: SpouseName First MI Last Birthdate: Maiden Name: Gender: Male Female Spouse Primary Phone: Spouse Cell Phone: Spouse Email: Sacraments received:Eucharist: Yes No Confirmed Catholic: Yes No Baptismal Status: Catholic Protestant Not Baptized Marriage Status: Single Catholic Marriage Other Marriage Widowed Divorced Additional information:Occupation: Place of Employment: Employer Phone: Additional Family MembersPlease have any family members over the age of 18 register independently.Add a Child: Add a child Child's InformationName First MI Last Birthdate: Gender: Male Female Sacraments received:Baptismal Status: Catholic Protestant Not Baptized Confirmed Catholic: Yes No Eucharist: Yes No Education:School Attending: Grade: All Saints Faith Formation Student: Yes No We would like to learn more about: Faith Formation classes Youth Ministry Altar Servers Add another child?Add another child Yes Child's InformationName First MI Last Birthdate: Gender: Male Female Sacraments received:Baptismal Status: Catholic Protestant Not Baptized Confirmed Catholic: Yes No Eucharist: Yes No Education:School Attending: Grade: All Saints Faith Formation Student: Yes No We would like to learn more about: Faith Formation classes Youth Ministry Altar Servers Add another child?Add another child Yes Child's InformationPhoneThis field is for validation purposes and should be left unchanged.
