Parish Registration

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone REQUIRED Please fill out this field. Please enter valid data.

Cell Phone REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter valid data.

How would you prefer to be contacted REQUIRED Please fill out this field.

Head of Household REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Marital Status Single Married Divorced Widower

Date of Marriage REQUIRED Please fill out this field. Please enter valid data.

Sacraments received REQUIRED Baptism Confirmation Eucharist(First Communion) Reconciliation(Confession) None of the above Please fill out this field.

Occupation Please enter valid data.

would you like to receive offering envelopes Yes No

Mass attendance Weekly Seldom

Spouse [if any] REQUIRED Please fill out this field. Please enter valid data.

Cell phone Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Sacraments received REQUIRED Baptism Confirmation Eucharist(First Communion) Reconciliation(Confession) None of the above Please fill out this field.

Occupation Please enter valid data.

CHILD/OTHER MEMBER

Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Male Female

Grade Level Please enter valid data.

Baptized

Baptism Date & Church of Baptism Please enter valid data.

Confirmation

Confirmation Date & Church Please enter valid data.

First Communion

First Communion Date & Church Please enter valid data.

CHILD/OTHER MEMBER

Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Male Female

Grade Level Please enter valid data.

Baptized

Baptism Date & Church of Baptism Please enter valid data.

Confirmation

Confirmation Date & Church Please enter valid data.

First Communion

First Communion Date & Church Please enter valid data.

CHILD/OTHER MEMBER

Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Male Female

Grade Level Please enter valid data.

Baptized

Baptism Date & Church of Baptism Please enter valid data.

Confirmation

Confirmation Date & Church Please enter valid data.

First Communion

First Communion Date & Church Please enter valid data.

CHILD/OTHER MEMBER

Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Male Female

Grade Level Please enter valid data.

Baptized

Baptism Date & Church of Baptism Please enter valid data.

Confirmation

Confirmation Date & Church Please enter valid data.

First Communion

First Communion Date & Church Please enter valid data.

CHILD/OTHER MEMBER

Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Male Female

Grade Level Please enter valid data.

Baptized

Baptism Date & Church of Baptism Please enter valid data.

Confirmation

Confirmation Date & Church Please enter valid data.

First Communion

First Communion Date & Church Please enter valid data.

2 days after you sent in your registration form please contact us if you need your child to be Baptized or you have any questions please call: 603-673-1311 or email: diane.st.patoffice@gmail.com

Saint Patrick

Catholic Church

Parish Registration

Registration