Registration Form Registration form for all four parishes. Parish Choice(Required) St. John the Evangelist St. Joseph St. Mary Nativity St. Therese Title Mr. & Mrs. Dr. & Mrs. Mr. Mrs. Ms. Family NamePhysical AddressMailing AddressCity/State/ZipEmail AddressPhone Number (Home)Phone Number (Other)Marital Status Married Single Widowed Separated Divorced Annulled Marriage InfoDate of Marriage MM slash DD slash YYYY Place of MarriageChurchCityStateIf OtherCityStateAre you transferring from some other parish? Yes No If yes, Church Name, City, and StateWould you like to reveive a copy of the Catholic Accent? Yes No Date MM slash DD slash YYYY Head of HouseholdReligious Status Catholic Non-Catholic Last NameFirst NameMiddleMaidenBirth Date MM slash DD slash YYYY OccupationRaceDate of Baptism MM slash DD slash YYYY ChurchCity/StateDate of First Eucharist MM slash DD slash YYYY ChurchCity/StateDate of Confirmation MM slash DD slash YYYY ChurchCity/StateSpouseReligious Status Catholic Non-Catholic Last NameFirst NameMiddleMaidenBirth Date MM slash DD slash YYYY OccupationRaceDate of Baptism MM slash DD slash YYYY ChurchCity/StateDate of First Eucharist MM slash DD slash YYYY ChurchCity/StateDate of Confirmation MM slash DD slash YYYY ChurchCity/StateFirst Child in ResidenceReligious Status Catholic Non-Catholic Last NameFirst NameMiddleRelationship to Head of HouseholdBirth Date MM slash DD slash YYYY RaceSexCurrent GradeSchool AttendingDate of Baptism MM slash DD slash YYYY ChurchCity/StateDate of First Eucharist MM slash DD slash YYYY ChurchCity/StateDate of Confirmation MM slash DD slash YYYY ChurchCity/StateSecond Child in ResidenceReligious Status Catholic Non-Catholic Last NameFirst NameMiddleRelationship to Head of HouseholdBirth Date MM slash DD slash YYYY RaceSexCurrent GradeSchool AttendingDate of Baptism MM slash DD slash YYYY ChurchCity/StateDate of First Eucharist MM slash DD slash YYYY ChurchCity/StateDate of Confirmation MM slash DD slash YYYY ChurchCity/StateThird Child in ResidenceLast NameFirst NameMiddleRelationship to Head of HouseholdBirth Date MM slash DD slash YYYY RaceSexCurrent GradeSchool AttendingDate of Baptism MM slash DD slash YYYY ChurchCity/StateDate of First Eucharist MM slash DD slash YYYY ChurchCity/StateDate of Confirmation MM slash DD slash YYYY ChurchCity/State Δ