Parish Registration

Thanks for taking a moment to register your household's information with our parish office.

Please fill out the form as completely as possible and then click submit.

Name of Husband

First Name

Last Name

Husband's Date of Birth

Name of Wife

First Name

Last Name

Wife's Date of Birth

First and Last Name(s) of Other Adult(s) in Household

First and Last Names of Child(ren) in Household

Primary Phone

Required* --

Secondary Phone

Email Address

Required*

Alternative Email Address

Home Address

Street 1

Street 2

City

State

Zip

Other Preferred Means of Communication? Please list here.

Is this information:
Required*

	Brand New Information?
	An Update to a Current Household Listing?

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