St. Patrick Registration Form

Please specify your membership status*

New MemberExisting Member

Previous Parish

Previous Parish City/State

Most likely Mass to Attend

Saturday Evening, 5:00Sunday Morning, 7:30Sunday Morning, 9:00Sunday Morning, 11:00

Full Name*

PrefixFirst NameMiddle NameLast Name

Nickname

If applicable

Maiden Name

If applicable

Marital Status*

Married in the Catholic Church?

YesNo

Anniversary Date

E-mail*

If none, type "none"

Home Phone

Please enter a valid phone number.

Cell Phone

Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Occupation

If retired, prior primary occupation

Employer

Work Phone

Birth Date*

Mother's Maiden Name

Used to track Sacraments

Baptized?*

YesNo

As Catholic?*

YesNo

First Reconciliation?*

YesNo

First Eucharist?*

YesNo

Confirmation?*

YesNo

RCIA?

YesNo

Current Religion

What year?

About what year?

Full Name

PrefixFirst NameMiddle NameLast Name

Nickname

If applicable

Maiden Name

If applicable

Cell Phone

E-mail

example@example.com

Occupation

If retired, prior primary occupation

Employer

Work Phone

Birth Date

Mother's Maiden Name

Used to track Sacraments

Baptized?

YesNo

As Catholic?

YesNo

First Reconciliation?

YesNo

First Eucharist?

YesNo

Confirmation?

YesNo

RCIA?

YesNo

Current Religion

What year?

About what year?

Parish Registration Form

Head of Household

Spouse

Children (Living at home)

Involvement in the Church

Liturgical Ministries

Involvement in the Church

Organizations

Study Groups

Hospitality Ministries

Religious Education

Technology & Communications

Activities & Fundraising

Outreach

Parish Directory Authorizations