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  • 2011 PARISH REGISTRATION Form

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    stpatschurch
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    ADDITIONAL INFORMATION REQUIRED UNDER ADULT #1 First Name: Gender: DOB (mm / dd / yyyy): Cell Phone: E-mail Address: Profession: Religion (if not Catholic): # Annointing of the Sick # Single # Separated # Married # Divorced # Widowed # Annulled Last Name DEPENDENT INFORMATION If you need to add additional members, please use a second form.

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    2011 PARISH REGISTRATION form

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    ADDITIONAL INFORMATION REQUIRED UNDER ADULT #1 First Name: Gender: DOB (mm / dd / yyyy): Cell Phone: E-mail Address: Profession: Religion (if not Catholic): # Annointing of the Sick # Single # Separated # Married # Divorced # Widowed # Annulled Last Name DEPENDENT INFORMATION If you need to add additional members, please use a second form.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    277 views1 page

    2011 PARISH REGISTRATION Form

    Uploaded by

    stpatschurch
    ADDITIONAL INFORMATION REQUIRED UNDER ADULT #1 First Name: Gender: DOB (mm / dd / yyyy): Cell Phone: E-mail Address: Profession: Religion (if not Catholic): # Annointing of the Sick # Single # Separated # Married # Divorced # Widowed # Annulled Last Name DEPENDENT INFORMATION If you need to add additional members, please use a second form.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    of 1

    CONFIDENTIAL MEMBERSHIP FORM

    St. Patrick Parish


    705 E. Jefferson Street, Washington, IL 61571 (309) 444-3524

    Date: Envelope No.: Member Since:


    Office use

    LAST NAME __________________________

    We are currently registered as members of St. Patrick Church. Please update the information we have provided. We are registering as new members of St. Patrick Church. We no longer attend St. Patrick's. Please remove the name and address we have provided from your database. HEAD OF HOUSEHOLD. ADDITIONAL INFORMATION REQUIRED UNDER ADULT #1 First Name: ______________________Middle Ini. _______ Unlisted; please do not share. Phone:

    Please Print

    Last Name: Address: City, State, Zip: Address 2:


    Vacation home

    Email:

    We check e-mail regularly and would like to receive correspondence & reminders from the parish via email.

    City, State, Zip:


    If applicable, please indicate approximate months in residence at vacation home (Ex: Jan-Feb).

    ADDITIONAL ADULT INFORMATION INCLUDING HEAD OF HOUSEHOLD (ADULT #1) First Name: Gender: DOB (mm/dd/yyyy): Cell Phone: E-mail Address: Profession: Religion (if not Catholic) I am interested in becoming Catholic ADULT #1. MF / (Maiden) / ADULT # 2. M F (Maiden) / /

    I am interested in becoming Catholic


    Reconciliation Baptism Communion Confirmation Marriage in the Church Annointing of the Sick Single Separated Married Divorced Widowed Annulled
    Present Grade K-16

    I have received the following sacraments: Marital Status:

    Reconciliation Baptism Communion Confirmation Marriage in the Church Annointing of the Sick Single Separated Married Divorced Widowed Annulled
    Last Name

    DEPENDENT INFORMATION
    If you need to add additional members, please use a second form.
    First Name
    (If different from Family Name) Relationship to Head of Household
    Religion if not Catholic Baptist, etc.

    Gender

    Date of Birth

    1.
    Check if Sacrament Received: Religious Education Attending:

    Baptism First Reconciliation First Communion Confirmation Adult Education Youth Ministry (CYM) CCD Grade School St. Patrick School Baptism First Reconciliation First Communion Confirmation Adult Education Youth Ministry (CYM) CCD Grade School St. Patrick School Baptism First Reconciliation First Communion Confirmation Adult Education Youth Ministry (CYM) CCD Grade School St. Patrick School Baptism First Reconciliation First Communion Confirmation Adult Education Youth Ministry (CYM) CCD Grade School St. Patrick School
    ADDITIONAL ADULTS IN HOUSEHOLD Please list, then complete a separate form. First Name: Relationship:

    MF MF MF MF

    2.
    Check if Sacrament Received: Religious Education Attending:

    3.
    Check if Sacrament Received: Religious Education Attending:

    4.
    Check if Sacrament Received: Religious Education Attending:

    PDF on Website

    Last Name:

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