Parish Registration Form

"*" indicates required fields

Household Info

Household Mailing Name*

Household Address*

Street Address Address Line 2 City State ZIP Code

Household Telephone Number*

Put cellphone if no landline

Head of Household

Name*

First Last

Gender*

Male

Female

Marital Status*

Single

Married

Catholic?*

Yes

Birth Date*

Cell Phone*

Email*

Occupation*

Sacraments Received

Check all that has been received

Baptism

First Communion

Confirmed

Marriage

None

Baptism Date

Church and City of Baptism*

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Marriage Date

Church and City of Marriage

Number of Children in Household?*

Spouse

Name*

First Last

Gender*

Male

Female

Catholic?*

Yes

Birth Date*

Cell Phone*

Email*

Occupation*

Sacraments Received*

Check all that has been received

Baptism

First Communion

Confirmed

None

Baptism Date

Church and City of Baptism

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Child #1

Name*

First Last

Gender*

Male

Female

Birth Date*

Sacraments Received*

Check all that has been received

Baptism

First Communion

Confirmed

None

Baptism Date

Church and City of Baptism*

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Child #2

Name*

First Last

Gender*

Male

Female

Birth Date*

Sacraments Received*

Check all that has been received

Baptism

First Communion

Confirmed

None

Baptism Date

Church and City of Baptism

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Child #3

Name*

First Last

Gender*

Male

Female

Birth Date*

Sacraments Received*

Check all that has been received

Baptism

First Communion

Confirmed

None

Baptism Date

Church and City of Baptism

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Child #4

Name*

First Last

Gender*

Male

Female

Birth Date*

Sacraments Received*

Check all that has been received

Baptism

First Communion

Confirmed

None

Baptism Date

Church and City of Baptism

First Communion Date

Church and City of First Communion

Confirmation Date

Church and City of Confirmation

Ministries

Indicate the ministries you are interested in participating in (Check all that apply)

Time & Talents at Worship

Time & Talent at Leadership

Parish Council

Finance

Worship

Fundraising

Time & Talent at Teaching

Children’s Catechesis & Sacramental Preparation

Youth Catechesis & Sacramental Preparation

Children’s or Youth Catechesis Assistant

Adult Catechesis & Sacramental Preparation

Evangelization

Time & Talent with Helping Hands

Additional Information

Sacraments

Is anyone in your family ready to celebrate a special sacrament in the coming year?

Baptism

First Reconciliation/First Communion (around age 7)

Confirmation (around age 11 or older)

Marriage

Enter Full Communion with the Catholic Church (adult Baptism or Confirmation)

If so, who will we be celebrating?

Have you, your spouse, and your adult children all been Confirmed in the Catholic Faith?

Yes

Please Explain

Have you celebrated your marriage in the Catholic Church, or otherwise had your marriage recognized in the Church?

Yes

Please Explain

Growing in Faith

Is there anything that is preventing you or a family member from fully participating in the Catholic Church?

What would help you, and your family, grow closer to God in the coming year?

What would you like to see most from your parish in the coming year?

First Fruits Evangelization

Who specifically will you and your family prayerfully invite to become Catholic, or become more active in their faith, during the coming year?

Would you like Father Adam, or someone from our Evangelization Team to reach out to this individual?

How are you planning to spread the mission of the Church in Central Bullitt County over the next year?

Tithing Intentions

By providing a tithing intention you are helping to hold yourself accountable. This information is also used for planning future staffing and projects around the parish.

My Annual Giving Intentions

How do you prefer to Tithe

Cash/Check in an envelope

Automatic Payment Processing from my bank/retirement account

ONLINE Giving (please set up an account with ParishSoft ONLINE Giving in the next section)

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