Registration
Membership Information Date__________
|
|
Head of Household |
Spouse |
|
Title: (Circle one) |
Mr. Mrs. Miss. Ms. Dr. Rev. Other _____ |
Mr. Mrs. Miss. Ms. Dr. Rev. Other ______ |
|
Name: First-Middle (Maiden) Last |
|
|
|
Preferred name |
|
|
|
Birthday: |
|
|
|
Marital Status: |
|
|
|
Anniversary Date: |
|
|
|
Address: City, State / Zip |
|
|
|
Home Phone: |
|
|
|
Cell Phone: |
|
|
|
Work Phone |
|
|
|
|
|
|
|
Fax #: |
|
|
|
Occupation: |
|
|
|
Employer: |
|
|
|
Date joined parish |
|
|
|
Religious Background |
|
|
|
Baptized: |
yes o no o Date: |
yes o no o Date: |
Children living at home
|
Name: First Middle and Last |
Birth Date |
Baptized |
Grade |
School |
|
|
|
yes o Date: |
|
|
|
|
|
yes o Date: |
|
|
|
|
|
yes o Date: |
|
|
|
|
|
yes o Date: |
|
|
|
|
|
yes o Date: |
|
|
|
|
|
yes o Date: |
|
|