Please answer YES if you are in need or interested in more information.

Ministry Have Needs Have Interest Administration: Bingo Facilities Maintenance Facilities Usage Office Help		Have Needs Have Interest Liturgy & Worship: Altar Servers Cenacle Group Charismatic Prayer Grp Children's Liturgy Church Cleaners Communion to Sick Eucharistic Ministers
Have Needs Have Interest Community Building: Bridge Marathon Coffee & Donuts Hilltoppers (Seniors) Knights of Columbus Mom's Bible Study Scouts (various)		Lectors Legion of Mary Music Ministry Traditional Choir (SATB) Handbell Choir Resurrection Chorale Children's Choir Instrumentalist ..Instrument? Contemporary Choir
Have Needs Have Interest Education: Adult Education Bible Study CCD (Rel. Edu.) R.C.I.A. Sacraments Baptism Confirmation Eucharist Marriage Penance School Youth Ministry		Rosary Makers Sacristans Ushers & Greeters Have Needs Have Interest Social Outreach: Bereavement CCSA Child Care Lay Pastors Nursing Ministry Pro-Life Stephen's Ministry Transportation Welcoming

Are there other needs you may have or are there other ways in which you would like to be involved in our Parish Community?

FAMILY INFORMATION

Family Name: (Last Only)

Address: Street City State Zip

Phone Number: Area Code Home Work/Cell

Phone Number Spouse: Area Code Home Work/Cell

Email Address: Spouse Email:

Mail addressed to?. Mr.. ....Mrs. .....Ms......Mr. & Mrs.....Dr......Dr. & Mrs.
Other:

Marital Status (Please Check One):

Married Single Divorced Separated Widowed

If married, did the marriage take place in the Catholic Church? Yes No

Wife's Maiden Name:

I/We will use envelopes? Yes No

Church Attendance: Regular Occasional Seldom

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FAMILY MEMBERS INFORMATION

FAMILY MEMBERS First and Middle Initial	Marital Status	Male/ Female	BIRTHDATE	RELIGION	ADULT’S OCCUPATION and EMPLOYER	SACRAMENTS (Approx. Date)
Head of Household: Occupation:	.	.	.	.	Employer: Phone:	Baptism Eucharist Confirmation Matrimony 1st Penance
Spouse: Occupation:	.	.	.	.	Employer: Phone:	Baptism Eucharist Confirmation Matrimony 1st Penance
CHILDREN:		(Print	1st and Last if	Different from	above.)

Child #1:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance
Child #2:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance
Child #3:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance
Child #4:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance
Child #5:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance
Child #6:	GENDER	BIRTHDATE	RELIGION:	Child's School: Child's Grade:	Baptism Eucharist Confirmation 1st Penance

INFORMATION CHANGE

New Parishioner

Put me on the mailing list & send Sunday Envelopes

Change of Address

New Phone Number

I am moving, remove me from the mailing list

Address Correction Requested

I am not currently a Catholic, but would like to know more about the Catholic Church.

I have a concern or question, or would like more information on: