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 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 Head of HouseholdReligious Status Catholic Non-Catholic Last NameFirst NameMiddleMaidenBirth Date OccupationRaceDate of Baptism ChurchCity/StateDate of First Eucharist ChurchCity/StateDate of Confirmation ChurchCity/StateSpouseReligious Status Catholic Non-Catholic Last NameFirst NameMiddleMaidenBirth Date OccupationRaceDate of Baptism ChurchCity/StateDate of First Eucharist ChurchCity/StateDate of Confirmation ChurchCity/StateFirst Child in ResidenceReligious Status Catholic Non-Catholic Last NameFirst NameMiddleRelationship to Head of HouseholdBirth Date RaceSexCurrent GradeSchool AttendingDate of Baptism ChurchCity/StateDate of First Eucharist ChurchCity/StateDate of Confirmation ChurchCity/StateSecond Child in ResidenceReligious Status Catholic Non-Catholic Last NameFirst NameMiddleRelationship to Head of HouseholdBirth Date RaceSexCurrent GradeSchool AttendingDate of Baptism ChurchCity/StateDate of First Eucharist ChurchCity/StateDate of Confirmation ChurchCity/StateThird Child in ResidenceLast NameFirst NameMiddleRelationship to Head of HouseholdBirth Date RaceSexCurrent GradeSchool AttendingDate of Baptism ChurchCity/StateDate of First Eucharist ChurchCity/StateDate of Confirmation ChurchCity/State Δ