Parish Registration - Our Lady Mother of the Church

Please complete the form below.
Fields marked with a red asterisk (*) are required

Family / Last *

Address 1 *

Address 2

City *

State

Zip

Phone Number *

Email

If you have children registered in St. John's Academy or our Religious Education Program, please indicate below

St. John's Academy

Religious Education Program

Total number of Family Members living in your home *

Member 1

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 2

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 3

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 4

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 5

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 6

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

Member 7

First Name *

Last or Maiden Name *

Birth Date (Mo/D/Yr) *

Gender

Male

Female

Marital Status *

Married

Single

Divorced

Widowed

If Married, Church of Marriage

Family Relation *

Husband

Wife

Child

Relative

Other - Please indicate in comments

Occupation / Student Current Grade

Religion *

Sacraments Received

Baptism

Penance

First Communion

Confirmation

Email if Applicable

Comments

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