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Parish Registration Form

* Are You Catholic? Yes   No  
Are you presently registered in this parish? Yes   No  
If yes, please state the year of original registration:
Were you previously registered parish in the Diocesse of Richmond? Yes   No  
If yes, please name the parish:
Location:
Are there any special circumstances or information of which the parish should be aware?
Head of Household
Title * First Name * Last Name Suffix
 
* Birth Date:   * Gender:  Female  Male
Personal Status:
Religion:
Disability:
Race/Ethnicity:
1st Language if not English 2nd Language:
Occupation:
Company/School:
Present Grade (children):
 

Sacraments Rcv      Date
Baptism
1st Comm
Confirm
Marriage
 
Address
* Line 1
   Line 2
* City
* State
* ZIP
   E-Mail
Send Email Instead of Mail When Possible
Phone
* Primary ( ) - Unlisted
   Other ( ) - Unlisted
 
 
Spouse
Title First Name Last Name Suffix
 
Birth Date:   Gender:  Female  Male
Personal Status:
Religion:
Disability:
Race/Ethnicity:
1st Language if not English 2nd Language:
Occupation:
Company/School:
Present Grade (children):
 

Sacraments Rcv      Date
Baptism
1st Comm
Confirm
Marriage
 
Address
Line 1
Line 2
City
State
ZIP
E-Mail
Send Email Instead of Mail When Possible
Phone
Primary ( ) - Unlisted
Other ( ) - Unlisted
 

Member 1 - Type

Title First Name Last Name Suffix
 
Birth Date:   Gender:  Female  Male
Personal Status:
Religion:
Disability:
Race/Ethnicity:
1st Language if not English 2nd Language:
Occupation:
Company/School:
Present Grade (children):
 
Sacraments Rcv      Date
Baptism
1st Comm
Confirm
Marriage
 
Add More Family Members
 
 
Directions to Residence
 
Upload A Family Photograph
 
Enter the Code: