Parish Registration "*" indicates required fields Last Name* Home Phone*Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Head of Household OneName First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipCell PhoneEmail BaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of First Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage I wish to receive SJCC Weekly Communication:* Yes No Do you have another family member to add? Yes No Head of Household Two (if applicable)Name First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipCell PhoneEmail BaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of FIrst Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage Do you have additional family member(s) to add? Yes No Additional Family MembersName First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipCell PhoneEmail BaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of FIrst Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage Additional Family MembersName First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipCell PhoneEmail BaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of FIrst Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage Additional Family MembersName First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipEmail Cell PhoneBaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of FIrst Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage Additional Family MembersName First Middle Last Suffix Household PositionPlease Choose One:Adult ChildCompanyGuest ChildMinor ChildHead of HouseholdOther AdultOther ChildUnknownDate of Birth MM slash DD slash YYYY Marital StatusPlease Choose One:SingleMarriedDivorcedWidowedSeparatedDomestic PartnershipCell PhoneEmail BaptismPlease Choose AnswerYesNoDate of Baptism MM slash DD slash YYYY Church of Baptism First EucharistPlease Choose AnswerYesNoDate of First Eucharist MM slash DD slash YYYY Church of FIrst Eucharist ConfirmationPlease Choose AnswerYesNoDate of Confirmation MM slash DD slash YYYY Church of Confirmation MarriagePlease Choose AnswerYesNoDate of Marriage MM slash DD slash YYYY Church of Marriage CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
