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Parishioner Registration form

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    Parishioner Registration form

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- Head of Household Information
  This is the person most responsible for managing the family information with the Church. This person will be the primary recipient of the various forms of communication from St. Anne's.
- Head of Household Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are you confirmed? Yes No
  
  Marital Status
  
  Marriage Date Please enter a date.
  
  Valid Catholic Marriage? Yes No
  
  Place of Marriage Please enter valid data.
  
  Occupation Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Special Needs and/or Talents?
- Second Adult Living at the Address
  This is typically the partner to the Head of Household.
- Second Adult
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are they confirmed? Yes No
  
  Occupation Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Special Needs and/or Talents?
- Other Members of the Household
  Select the number of additional adults living in the household (limit 4) and then select the number of children in the home (limit 10). If you need more options, please contact Anne at the parish office to assist you with your registration.
- Other Adults Living at this Address REQUIRED Please fill out this field.
  
  Adult 1
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are they confirmed? Yes No
  
  Occupation Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Special Needs and/or Talents?
  
  Adult 2
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are they confirmed? Yes No
  
  Occupation Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Special Needs and/or Talents?
  
  Adult 3
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are they confirmed? Yes No
  
  Occupation Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Special Needs and/or Talents?
  
  Adult 4
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Religion Please enter valid data.
  
  Are they confirmed? Yes No
  
  Occupation Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Special Needs and/or Talents?
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 2
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 3
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 4
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 5
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 6
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 7
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 8
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 9
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
  
  Child 10
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter a date.
  
  Sacraments Received? Baptism Eucharist Confirmation
  
  Special Needs and/or Talents?
- Mailing Information
  Please provide your US Postal Mail information.
- Your Address
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  Address Line 2 Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
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Parishioner Registration form

Head of Household Information

Second Adult Living at the Address

Other Members of the Household

Mailing Information