Parish Registration Form - St. Mary Catholic Church
ST. MARY PARISH FAMILY REGISTRATION FORM FAMILY PAGE: Please return to the parish office when complete. Last Name _________________________________________________________________________ Family Name _______________________________________________________________________ (e.g. Mr. & Mrs. John Doe or Ms. Jane Doe) Street Address ________________________________________________________________ City/State ________________________________________ Zip ___________plus 4________ Date Registered __________________________________ Family Household Status (circle one) Single Married Divorced Widowed Engaged Family Telephone Number: ________________________________________ Unlisted: Yes No Family e-mail ______________________________________Send e-mail when possible? Yes No Send Weekly Parish Update via e-mail? Yes No Would you like a tour of the parish facilities? Yes No Sunday Offertory: ____Envelopes ____Direct Debit (Please register at www.faithdirect.net–code OH225) List each family member: 1.____________________________ 2.___________________________ 3.____________________________ 4.___________________________ 5.____________________________ 6.___________________________ Seasonal Alternate Address: Active from _______month ______ day to _________month ______ day Street Address ________________________________________________________________ City/State ________________________________________ Zip ________________________ Additional Remarks ____________________________________________________________________ ____________________________________________________________________________________ Registration continues on the following pages for each family member. MEMBER 1 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss II Ms. Dr. Other ____________________ III IV None Other _______________ Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ MEMBER 2 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss II Ms. Dr. Other ____________________ III IV None Other _______________ Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ * Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ MEMBER 3 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss II Ms. Dr. Other ____________________ III IV None Other _______________ Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ * Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ MEMBER 4 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss II Ms. Dr. Other ____________________ III IV None Other _______________ Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ * Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ MEMBER 5 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss II Ms. Dr. Other ____________________ III IV None Other _______________ Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ * Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ MEMBER 6 PAGE: Please complete one member page for each member of your family Last Name ________________________ First Name ___________________ Middle Name ________________ Gender ______Nickname ________________________ Maiden Name __________________________ Title (circle one) Mr. Suffix (circle one) Mrs. Jr. Sr. Miss Ms. Dr. Other ____________________ III IV None Other _______________ II Relationship: Husband, wife, daughter, son, etc. ____________________________________________________ Birthdate ____________________________ City/State of Birth ______________________________________ Member Status (circle one) Single Married Divorced Widowed Engaged Highest Grade Completed _____________ Language Spoken (other than English)____________________________________ Religion _____________________________________ Disability _____________________________________ Occupation __________________________________ Ethnicity _____________________________________ Personal Cell Phone Number _____________________ Personal e-mail ________________________________ Baptism Date ________________________________________ Baptismal Name ______________________________ * Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________________________________ Godfather _____________________________ & Godmother__________________________________ Reconciliation (circle one) Yes No 1st Communion - Date ___________________ Church Name _________________ City/State ______________ Administered by ______________________________________________ Confirmation - Date _____________________ Confirmation Name ________________ Sponsor _____________ Church Name ________________________________ City/State ______________________________ Administered by ______________________________________________ Marriage - Date _____________________ Church Name _________________ City/State _________________ Administered by ______________________________________________ Married (circle one) by priest by minister in a civil ceremony other Weekend Mass Attendance (circle one) Weekly Monthly Occasionally Additional Remarks ___________________________________________________________________________ For Office Use Only ID# PDS: Env: Excel: Welcome Committee: Weekly Update: Please return to: St. Mary Church 340 North Main Street Hudson, OH 44236 330.653.8118 Parish registration is official when this completed registration form is returned to the Parish Office by mail or in person. Updated 03/2012
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