New Parishioner Registration Form New Parishioner Census Form Name (Head of Household) Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Middle Last Suffix Birthdate (Head of Household) MM slash DD slash YYYY Sex Male Female Prefer not to respond Employment (Head of Household) Full Time Part Time Retired Not employed outside of the home Please indicate your occupation and employer (Head of household). Please indicate the highest educational degree received (Head of Household).Graduate SchoolCollege/Trade SchoolHigh SchoolPlease indicate your religion (Head of Household). Marital Status Married Single Window Separated Divorced If you are married, was it a Church marriage? Yes No If married, please provide the date of your marriage. MM slash DD slash YYYY If you were married outside of the Church, would you like to have your marital status reviewed? Yes No Baptized (Head of Household) Yes No Date of Baptism (Head of Household) MM slash DD slash YYYY First Penance (Head of Household) Yes No Date of First Penance (Head of Household) MM slash DD slash YYYY First Communion (Head of Household) Yes No Date of First Communion (Head of Household) MM slash DD slash YYYY Confirmed (Head of Household) Yes No Date of Confirmation (Head of Household) MM slash DD slash YYYY Spouse's Name Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Middle Last Suffix Spouse's Maiden Name (If it applies) Birthdate (Spouse) MM slash DD slash YYYY Sex Male Female Prefer not to respond Employment (Spouse) Full Time Part Time Retired Not employed outside of the home Please indicate your occupation and employer (Spouse). Please indicate the highest educational degree received (Spouse).Graduate SchoolCollege/Trade SchoolHigh SchoolPlease indicate your religion (Spouse). Baptized (Spouse) Yes No Date of Baptism (Spouse) MM slash DD slash YYYY First Penance (Spouse) Yes No Date of First Penance (Spouse) MM slash DD slash YYYY First Communion (Spouse) Yes No Date of First Communion (Spouse) MM slash DD slash YYYY Confirmation (Spouse) Yes No Date of Confirmation (Spouse) MM slash DD slash YYYY Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home PhoneCell Phone (Head of Household)Cell Phone (Spouse)Email (Head of Household) Email (Spouse) Do you have other adults or children living in your household? Yes No If applicable, how many additional adults or children are living in your household?Name (Adult/Child #1 living in your home) First Last Birthdate (Adult/Child #1) MM slash DD slash YYYY Sex (Adult/Child #1) Male Female Prefer not to respond Please indicate the highest educational degree received or current grade (Adult/Child #1).Graduate SchoolCollege/Trade SchoolHigh School12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st GradeKindergartenPre-SchoolNot in school yetBaptised (Adult/Child #1) Yes No Date of Baptism (Adult/Child #1) MM slash DD slash YYYY First Penance (Adult/Child #1) Yes No Date of First Penance (Adult/Child #1) MM slash DD slash YYYY First Communion (Adult/Child #1) Yes No Date of First Communion (Adult/Child #1) MM slash DD slash YYYY Confirmation (Adult/Child #1) Yes No Date of Confirmation (Adult/Child #1) MM slash DD slash YYYY Name (Adult/Child #2 living in your home) First Last Birthdate (Adult/Child #2) MM slash DD slash YYYY Sex (Adult/Child #2) Male Female Prefer not to respond Please indicate the highest educational degree received or current grade (Adult/Child #2).Graduate SchoolCollege/Trade SchoolHigh School12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st GradeKindergartenPre-SchoolNot in school yetBaptized (Adult/Child #2) Yes No Date of Baptism (Adult/Child #2) MM slash DD slash YYYY First Penance (Adult/Child #2) Yes No Date of First Penance (Adult/Child #2) MM slash DD slash YYYY First Communion (Adult/Child #2) Yes No Date of First Communion (Adult/Child #2) MM slash DD slash YYYY Confirmation (Adult/Child #2) Yes No Date of Confirmation (Adult/Child #2) MM slash DD slash YYYY Name (Adult/Child #3 living in your home) First Last Birthdate (Adult/Child #3) MM slash DD slash YYYY Sex (Adult/Child #3) Male Female Prefer not to respond Please indicate the highest educational degree received or current grade (Adult/Child #3).Graduate SchoolCollege/Trade SchoolHigh School12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st GradeKindergartenPre-SchoolNot in school yetBaptized (Adult/Child #3) Yes No Date of Baptism (Adult/Child #3) MM slash DD slash YYYY First Penance (Adult/Child #3) Yes No Date of First Penance (Adult/Child #3) MM slash DD slash YYYY First Communion (Adult/Child #3) Yes No Date of First Communion (Adult/Child #3) MM slash DD slash YYYY Confirmation (Adult/Child #3) Yes No Date of Confirmation (Adult/Child #3) MM slash DD slash YYYY Name (Adult/Child #4 living in your home) First Last Birthdate (Adult/Child #4) MM slash DD slash YYYY Sex (Adult/Child #4) Male Female Prefer not to respond Please indicate the highest educational degree received or current grade (Adult/Child #4).Graduate SchoolCollege/Trade SchoolHigh School12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st GradeKindergartenPre-SchoolNot in school yetBaptized (Adult/Child #4) Yes No Date of Baptism (Adult/Child #4) MM slash DD slash YYYY First Penance (Adult/Child #4) Yes No Date of First Penance (Adult/Child #4) MM slash DD slash YYYY First Communion (Adult/Child #4) Yes No Date of First Communion (Adult/Child #4) MM slash DD slash YYYY Confirmation (Adult/Child #4) Yes No Date of Confirmation (Adult/Child #4) MM slash DD slash YYYY Name (Adult/Child #5 living in your home) First Last Birthdate (Adult/Child #5) MM slash DD slash YYYY Sex (Adult/Child #5) Male Female Prefer not to respond Please indicate the highest educational degree received or current grade (Adult/Child #5).Graduate SchoolCollege/Trade SchoolHigh School12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st GradeKindergartenPre-SchoolNot in school yetBaptized (Adult/Child #5) Yes No Date of Baptism (Adult/Child #5) MM slash DD slash YYYY First Penance (Adult/Child #5) Yes No Date of First Penance (Adult/Child #5) MM slash DD slash YYYY First Communion (Adult/Child #5) Yes No Date of First Communion (Adult/Child #5) MM slash DD slash YYYY Confirmation (Adult/Child #5) Yes No Confirmation (Adult/Child #5) MM slash DD slash YYYY Please indicate which member(s), if any, in your household are currently participating in religious education.Head of HouseholdSpouseAdult/Child #1Adult/Child #2Adult/Child #3Adult/Child #4Adult/Child #5Does anyone in your home have a disability? Yes No If you answered yes to the above question, please indicate which member(s) in your family and the disability.Please indicate any special needs of anyone in your family (such as aged, housing, medical, employment, occupational training, day nursery care, or other).Please list any talents of skills (E.g., carpenter, child care, public relations, librarian, computer expert, electrician, financial expert, musical instrument, vocalist, nurse, plumber, teacher, artist, secretary, etc.)Is there anything else that you would like to share with us?NameThis field is for validation purposes and should be left unchanged. Δ
