Parish Registration Form

Family Name*

Phone*

Primary Email*

Date of Registration*

Address*

Street Address Address Line 2 City State ZIP Code

Family Members

Please only include family members that currently live in your home.

Head of Household*

Name	Birth Date	Religion	Baptism Date	Communion Date	Confirmation Date	Occupation & Employment

Spouse

Name	Birth Date	Religion	Baptism Date	Communion Date	Confirmation Date	Occupation & Employment

Single Adult

Please click the + icon on the right to add another single adults.

Name	Birth Date	Religion	Baptism Date	Communion Date	Confirmation Date	Occupation & Employment

Child(ren)

Please click the + icon on the right to add another child.

Name	Birth Date	Religion	Baptism Date	Communion Date	Confirmation Date	Occupation & Employment

Ethnicity*

Are you a full-time resident?*

Yes
No

If not, what months are you usually here?*

Previous Parish*

Marital Status*

Single
Married
Divorced/Separated
Widow/Widower

If married, were you married in the Catholic Church or has the Catholic Church "blessed" your marriage?*

Yes
No

Wedding Anniversary Date*

Contribution Envelopes

Please use the contribution envelopes that you will receive in the mail. Using your envelopes insures accurate records and enables us to provide you with an account of your yearly contributions for income tax purposes. Please consider electronic giving. Thank you!

Stewardship & Ministries

We urge you to be responsible stewards of God’s gifts by contributing a meaningful portion of your time, talent & treasure to the life of the parish.
Please indicate those areas where you would like to participate:

Faith Formation

Fellowship

Bereavement Support for Families
Prime-Timers (Age 55+)
Repast Meals (at PBOC)
Special Parish Events (Socials)

Outreach

Prayer & Worship

(Training will be provided. Both men and women are welcome.)

Parish & Community Ministries/Organizations

Birthright
Church Gift Shop
Cursillo
Knights of Columbus
Padre Pio Prayer Group
Prayer Shawls (at home/at church)
Rosary Makers (at home/at church)
St. John of the Cross Group
Women’s Club

Skills, Personal Interests, Hobbies

Photography
Languages
Other

Languages*

Other Skills, Personal Interests, Hobbies*

By checking any of these stewardship opportunities, you are giving the parish office and corresponding program heads permission to contact you the household.