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  • Registration Date REQUIRED Please fill out this field. Please enter valid data.
  • I am registering for: REQUIRED St. Mary's St. Joseph-St. Therese Our Lady of Fatima Please fill out this field.
  • Previous Parish (if you attended another parish previously) Please enter valid data.
  • Household Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Address REQUIRED Please fill out this field. Please enter valid data.
  • Address Line 2 Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Email (best one to use for family contact) REQUIRED Please fill out this field. Please enter an email address.
  • Phone Number (best one to use for family contact) REQUIRED Please fill out this field. Please enter a phone number.
  • ADULT #1
  • Include Middle Initial or Middle Name with First Name
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Maiden Name (if applicable) Please enter valid data.
  • Birthdate REQUIRED Please fill out this field. Please enter valid data.
  • Status REQUIRED Single/Head of Household Married/Head of Household Divorced/Head of Household Widowed/Head of Household Please fill out this field.
  • If married, who were you married by? Catholic Priest or Deacon Other (Justice of the Peace or non Catholic Clergy)
  • Sacraments Received REQUIRED

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    Baptism Eucharist (First Communion) Confirmation None of the Above Please fill out this field.
  • Occupation (if retired-enter retired) REQUIRED Please fill out this field. Please enter valid data.
  • Personal Email Please enter an email address.
  • Cell Phone Number Please enter valid data.
  • ADULT #2
  • Include Middle Initial or Middle Name with First Name
  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Maiden Name (if applicable) Please enter valid data.
  • Birthdate Please enter valid data.
  • Status of Adult #2 Wife Husband Other Adult in Household
  • Status Single Married Divorced Widowed
  • If married, who were you married by? Catholic Priest or Deacon Other (Justice of the Peace or non Catholic Clergy)
  • Sacrament Received

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    Baptism Eucharist (First Communion) Confirmation None of the Above
  • Occupation (if retired-enter retired) Please enter valid data.
  • Personal Email Please enter an email address.
  • Cell Phone Number Please enter valid data.
  • Use this area to list any additional adults living in the home using the above categories
  • Children and School Grade Level
  • Child #1
  • Include Middle Initial or Middle Name with First Name
  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Birthdate Please enter valid data.
  • Grade in school None Pre-school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College
  • School where child attends Please enter an email address.
  • Sacraments Received

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    Baptism Eucharist (First Communion) Confirmation None of the Above
  • Church of Baptism

    Church, City, State

    Please enter valid data.
  • Child #2
  • Include Middle Initial or Middle Name with First Name
  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Birthdate Please enter valid data.
  • Grade in school None Pre-school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College
  • School where child attends Please enter an email address.
  • Sacraments Received

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    Baptism Eucharist (First Communion) Confirmation None of the Above
  • Church of Baptism

    Church, City, State

    Please enter valid data.
  • Child #3
  • Include Middle Initial or Middle Name with First Name
  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Birthdate Please enter valid data.
  • Grade in school None Pre-school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College
  • School where child attends Please enter an email address.
  • Sacraments Received

    Check all that apply

    Baptism Eucharist (First Communion) Confirmation None of the Above
  • Church of Baptism

    Church, City, State

    Please enter valid data.
  • Use this area to list any addition children following the above categories

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