Family Registration Form

Welcome to St. Joseph Parish

We invite parishioners so that we can get to know you and serve you better. By registering yourself and your family, you will receive important communications about what is happening in our parish and a record of your contributions for tax purposes each year. If you live at the same address with members of your extended family or adult children age 21 or older, please invite them to register separately. All the information you provide is kept strictly confidential.

Family Information

Head of Household

Title

First Name*

Last Name*

Name of Spouse

Title

First Name

Last Name

Family Status

(Choose one)

	Single
	Catholic marriage
	Civil marriage
	Separated
	Widowed
	Divorced

Home Address

Street 1

Street 2

City

State

Zip

Email Address

Alternative Email Address

Primary Phone

Required* --

Secondary Phone

--

Other Preferred Means of Communication? Please list here.

Is this information:
Required*

	Brand New Information?
	An Update to a Current Household Listing?

PERSONAL INFORMATION – HEAD OF HOUSEHOLD

Gender

	Male
	Female

Date of Birth

//

Ethnicity

Religion

Occupation

Employer

Location

Baptism

	Yes
	No

Date of Baptism

//

Church Name and Location where Baptism took place

Eucharist

	Yes
	No

Date of Eucharist

//

Church Name and Location where Eucharist took Place

Confirmation

	Yes
	No

Date of Confirmation

//

Church Name and Location where Confirmation took Place

Marriage

	Yes
	No

Date of Marriage

//

Church Name and Location where Marriage took Place

PERSONAL INFORMATION – SPOUSE

Gender

	Male
	Female

Date of Birth

//

Ethnicity

Religion

Occupation

Employer

Location

Baptism

	Yes
	No

Date of Baptism

//

Church Name and Location where Baptism took place

Eucharist

	Yes
	No

Date of Eucharist

//

Church Name and Location where Eucharist took Place

Confirmation

	Yes
	No

Date of Confirmation

//

Church Name and Location where Confirmation took Place

Marriage

	Yes
	No

Date of Marriage

//

Church Name and Location where Marriage took Place

PERSONAL INFORMATION – DEPENDENTS

Name

First Name

Last Name

Relationship

	Son
	Daughter
	Mother
	Father
	other

If student, grade in school

Gender

	Male
	Female

Date of Birth

//

Ethnicity

Religion

Sacraments

Has this family member recieved

Baptism

	Yes
	No

Date of Baptism

//

Church Name and Location where Baptism took place

Eucharist

	Yes
	No

Date of Eucharist

//

Text (Single Line)

PERSONAL INFORMATION – SPOUSE