Parish Registration Form   Personal Information   Family Name: Street Address Apartment # City State Zip Code Home Telephone # Unlisted Wife's Maiden Name Married by Catholic Priest? Yes No      Yes No   Name of Church Date Married City and State     Head of House      1 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   Spouse      2 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   Children      3 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   4 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   5 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   6 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   7 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   Other Adults (not children)      8 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   9 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic Baptist Congregational Episcopalian Lutheran Metdodist Presbyterian Jewish No Religion Other --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Daily Weekly Bi-Monthly Monthly Christmas/Easter Does not attend --- Altar Server Cantor Catechist Carnation Committee Church Decorator Church Cleaning: God's Housekeeper's Church Cleaning: tde Martha's Extraordinary Minister of Holy Communion Finance Council Lector Liturgy Committee Miraculous Medal Society Palm Braiders Pastoral Council Procession Committee R.C.I.A. Catechist Sacred Heart Society Secular Carmelities Senior Citizens-Leisure Timers Group Senior Citizens-Palumbo Group Senior Citizens-Young at Heart Group Sunday Tellers Ushers Women's Club   10 First Name Middle Initial Last Name Relationship in the Family (husband, wife, son, etc.) Baptized First Comm. Confirmed --- Yes No --- Yes No --- Yes No Birthdate(M/D/Y) Special Problems Marital Status Ethnicity --- Blind Deaf Mental Handicap Physical Handicap Shut - In --- Valid Marriage Invalid Marriage Single Parent Single Living togetder Separated Divorced Divorced/Annuled Widow/Widower --- White Hispanic, Cuban Hispanic, Dominican Hispanic, Mexican Hispanic, Puerto Rican Other Hispanic Black, African American Black, African (Liberian, Nigerian) Black, Haitian Other Black (including Caribbean etc.) Asian, Chinese Asian, Filipino Asian, Indian Asian, Korean Asian, Vietnamese Other Asian (including Hmong, Indonesian, Japanese etc. ) American Indian, Hawaiian or Other Pacific Islander Other Race Multi-Racial Family Members away from home Religion Church Attendance Receiving Communion Church Activities --- College Armed Forces Nursing Home Other --- Catholic