St. Francis of Assisi Parish Registration Form
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Household Information
Address:
City: 
Zipcode:
 Home Phone: 
Language(s) Spoken at home (other than English):
Ethnic Origin(s) of family members
(please check all that apply)		 African-American
Asian
Caucasian
Hawaiian/Pacific Islander
Latino (please specify country)
     
Native American
Other: 

Individual Information
Head of Household
  Do you want Contribution EnvelopesYes No
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Work Phone: 
Gender
 Marital Status Religion Sacraments Received Occupation
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony		 Please choose the closest match from this list
 
and type in a better description if appropriate
Click here if you have finished entering information for the entire household
Spouse
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Work Phone: 
Gender
 Marital Status Religion Sacraments Received Occupation
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony		 Please choose the closest match from this list
 
and type in a better description if appropriate
Click here if you have finished entering information for the entire household
 
Additional person (3rd)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony
Click here if you have finished entering information for the entire household
 
Additional person (4th)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony
Click here if you have finished entering information for the entire household
 
Additional person (5th)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony
Click here if you have finished entering information for the entire household
 
Additional person (6th)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony
Click here if you have finished entering information for the entire household
 
Additional person (7th)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony
Click here if you have finished entering information for the entire household
 
Additional person (8th)
 Child Other
Mr/Mrs/Dr etc
(only if you want us to use it)		 First Name Last Name
Date of Birth 
(mm/dd/yyyy)
Email Address: 
 Grade in School: 
Gender
 Marital Status Religion Sacraments Received
Male
Female 		 Single
Married
Widowed
Divorced 		 Catholic
Other 		 Baptism
1st Communion
Reconciliation
Confirmation
Matrimony

When you have entered all of your information, press the submit button below:

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