NEW PARISHIONER REGISTRATION FORM (Please PRINT)
Family Name (last name only): ______________________________________________________________
Mailing Address: __________________________________________________________________________ Number Street (Apt.) City State Zip
Home Phone or Primary Phone: ___________________________
FEMALE
________________________________________
___________________ Maiden: _____________
________________________________________
________________________________________
MALE
First Name: ______________________________________
Middle Name: ____________________________________
Email Address: ____________________________________
Cell Number: _____________________________________
Date of Birth: _____________________________________ ________________________________________
Religion: _________________________________________ ________________________________________
Marital Status (check one): Single Married Separated Divorced Widow/Widower
How did you find out about SCS? _________________________________________________________________
CHILDREN LIVING AT HOME: (Please include this same information on the reverse side for additional children)
Full Name: _________________________________________ Date of Birth: _________________________
Gender: __________ Religion: ___________ Relationship: _________________________________
Full Name: _________________________________________ Date of Birth: _________________________
Gender: _________ Religion: ____________ Relationship: _________________________________
Full Name: __________________________________________ Date of Birth: ________________________
Gender: _________ Religion: ____________ Relationship: _________________________________
Full Name: __________________________________________ Date of Birth: ________________________
Gender: _________ Religion: ____________ Relationship: _________________________________
Thank you for registering at St. Catherine of Siena! We welcome you to our parish!
Full Name: __________________________________________ Date of Birth: ________________________
Gender: _________ Religion: ____________ Relationship: _________________________________
Completed form may be sent to Parish Office via mail or email to [email protected]