Parish Registration

Family Contact Information

Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City, State, and Zip Code REQUIRED Please fill out this field. Please enter valid data.
Home Phone REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Please enter valid data.
Email Address REQUIRED Please fill out this field. Please enter an email address.

Head of Household #1

First Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
Marital Status REQUIRED Please fill out this field.
Married By REQUIRED Please fill out this field.
Date of Marriage Please enter a date.
Religion REQUIRED Please fill out this field. Please enter valid data.
Gender REQUIRED Male Female Please fill out this field.
Cell Phone Please enter valid data.
Email Address Please enter valid data.
Employer Please enter valid data.
Occupation Please enter valid data.
Work Phone Please enter valid data.
Have you been baptized? REQUIRED Please fill out this field.
Have you received your 1st communion? REQUIRED Please fill out this field.
Have you received the sacrament of confirmation? REQUIRED Please fill out this field.
How often do you go to confession? REQUIRED Please fill out this field.
Please list any ministries you are interested in knowing more about: REQUIRED Please fill out this field.

Head of Household #2

First Name REQUIRED
(If there is no other head of household please enter "N/A" in the box above.)
Please fill out this field. Please enter valid data.
Last Name Please enter valid data.
Maiden Name Please enter valid data.
Date of Birth Please enter a date.
Marital Status
Married By
Date of Marriage Please enter a date.
Religion Please enter valid data.
Gender Male Female
Cell Phone Please enter valid data.
Email Address Please enter valid data.
Employer Please enter valid data.
Occupation Please enter valid data.
Work Phone Please enter valid data.
Have you been baptized?
Have you received your 1st communion?
Have you received the sacrament of confirmation?
How often do you go to confession?
Please list any ministries you are interested in knowing more about:

Child #1

First Name REQUIRED
(If you do not have any children please enter "no children" in the box above.)
Please fill out this field. Please enter valid data.
Last Name Please enter valid data.
Date of Birth Please enter a date.
Gender Female Male
School Grade Please enter valid data.
Baptism
1st Communion
Confirmation
How often do you take your child to confession?
List Ministries of Interest:

Child #2

Child #3

Child #4

Child #5

Child #6

Saint Anthony Catholic Church