More Than 3

Date

Name

First Name

Last Name

Address1

Address 2

City

State

Zip

Home Phone

Area Code

Phone First 3

Phone Last 4

Family Email

Emergency Contact

Would you like to be contacted by a member of the pastoral staff?

Yes

No

Would you like to make church offerings using EFT?

Yes

No

Would you like to make church offerings using Envelopes?

Yes

No

Are you not making offerings at this Time?

Yes

No

(If you choose EFT or envelopes, we will be able to provide you with an end of year statement of your donations.)

Individual Adult Member Information: ** Please fill in the principle contact/primary contact for your family first

First Name

Last Name

Gender

D.O.B.

Email

Cell Phone

Area Code

Phone First 3

Phone Last 4

Work Phone

Area Code

Phone First 3

Phone Last 4

Employer

Occupation

Baptized?

Catholic

Select all Sacraments received:

Reconciliation

First Eucharist

Confirmation

Marital Status

Single

Married

Separated

Divorced

Widowed

Married in Catholic Church?

Date of Marriage

Individual Adult Member Information:

First Name

Last Name

Gender

Role (Relationship to the Above)

D.O.B.

Email Address

Cell Phone

Area Code

Phone First 3

Phone Last 4

Work Phone

Area Code

Phone First 3

Phone Last 4

Employer

Occupation

Baptized

Catholic

Select all Sacraments received

Reconciliation

First Eucharist

Confirmation

Marital Status

Single

Married

Separated

Divorced

Widowed

Dependent Children Information:

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High School graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High School graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High School graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Gender

D.O.B.

Relationship to head of household

Place of Birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

Name

First Name

Last Name

Gender

D.O.B.

Relationship to head of household

Place of birth

Name of School currently attending

High school graduation year

Baptized?

Catholic?

Select all sacraments received

Reconciliation

First Eucharist

Confirmation

New Parishioner Registration

ST. PETER THE APOSTLE CATHOLIC CHURCH