Saint Mary of the Annunciation Parish Registration Form

Who should be registered? Only those members of your household who live at the same address and who attend Mass at Saint Mary of the Annunciation regularly.

FAMILY INFORMATION
Last Name
Street Address
P. O. Box and Zip, if applicable
City - State - Zip Code
House Landline (no Cell) House Landline (no Cell) - ### - ### ####
How long have you lived at this address?
From which church are you transferring your membership?
(Please notify that church of your change.)
MEMBERS
ADULT 1 ADULT 1 Title First Middle Last Suffix
Preferred Name / Nickname
Marital Status

Marital Status Single Engaged Married in the Catholic Church Married in a non-Catholic ceremony but with canonical dispensation from the Catholic Church Married outside the Catholic Church and without dispensation from the Catholic Church Widowed Divorced
Date of Birth Date of Birth / MM / DD YYYY
Religion
Catholic Sacraments received

Catholic Sacraments received None Baptism Eucharist Confirmation Matrimony Anointing of the Sick
Church and city where Baptized
Cell Phone Cell Phone - ### - ### ####
Email
Occupation and location
Any special needs or concerns?
ADULT 2 ADULT 2 Title First Middle Last Suffix
Preferred Name / Nickname
Marital Status

Marital Status Single Engaged Married in the Catholic Church Married in a non-Catholic ceremony but with canonical dispensation from the Catholic Church Married outside the Catholic Church and without dispensation from the Catholic Church Widowed Divorced
Date of Birth Date of Birth / MM / DD YYYY
Religion
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Matrimony Anointing of the Sick
Church and city where Baptized
Cell Cell - ### - ### ####
Email
Occupation and location
Any special needs or concerns?
CHILD 1 CHILD 1 First Middle Last
Preferred Name / Nickname
Date of Birth Date of Birth / MM / DD YYYY
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Anointing of the Sick
Name of church and city where Baptized
School name and current grade
Any special needs or concerns?
CHILD 2 CHILD 2 First Middle Last
Preferred Name / Nickname
Date of Birth Date of Birth / MM / DD YYYY
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Anointing of the Sick
Name of Church and City where Baptized
School Name and Current Grade
Any Special Needs or Concerns?
CHILD 3 CHILD 3 First Middle Last
Preferred Name / Nickname
Date of Birth Date of Birth / MM / DD YYYY
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Anointing of the Sick
Name of church and city where Baptized
School Name and Current Grade
Any Special Needs or Concerns
CHILD 4 CHILD 4 First Middle Last
Preferred Name / Nickname
Date of Birth Date of Birth / MM / DD YYYY
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Anointing of the Sick
Name of Church and City Where Baptized
School Name and Current Grade
Any Special Needs or Concerns
CHILD 5 CHILD 5 First Middle Last
Preferred Name / Nickname
Date of Birth Date of Birth / MM / DD YYYY
Catholic Sacraments Received

Catholic Sacraments Received None Baptism Eucharist Confirmation Matrimony
Name of church and city where Baptized
School name and current grade
Any special needs or concerns?

Saint Mary of the Annunciation Parish Registration Form

Saint Mary of the Annunciation Parish Registration Form

FAMILY INFORMATION

MEMBERS