"*" indicates required fields Name of Head of Household for Family* First Last Which serve time do you prefer 4:30 11:30 Are there any changes to your record?* Yes No If Yes, What Changes need to be made?Check all that apply Address Phone Number Email Added Child Added Adult Parent Update AddressNew Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone NumberNew Phone Number*What is this phone number for? Ex. Home or Cell*Would you like this published?* Yes No Email AddressNew Email Address* Added ChildChild's Name* First Last Gender* Male Female Birth Date*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sacraments Received*Check all that has been received Baptism First Communion Confirmed None Baptism DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of BaptismFirst Communion DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of First CommunionConfirmation DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of ConfirmationAdded Adult ParentName of Parent* First Last Gender* Male Female Marital Status* Single Married Catholic?* Yes No Birth Date*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Cell PhoneEmail OccupationSacraments ReceivedCheck all that has been received Baptism First Communion Confirmed None Baptism DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of BaptismFirst Communion DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of First CommunionConfirmation DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Church and City of ConfirmationMinistriesIndicate the ministries you are interested in participating in (Check all that apply)Time & Talents at Worship Eucharistic Minister Lector Jr Lector Choir/Music Sacristan Server (Youth) Server (Adult) Greeter Children’s Liturgy Art & Environment Church Cleaning Usher Hospital Visits Home Visits Prison Visits Prayer Cleaning Linens Time & Talents at Leadership Parish Council Finance Council Worship Council Fundraising Time & Talents 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 Maintenance Answering Phones Large Mailings Data Entry Bereavement Money Counters Seek Donations Food Prep General Volunteer Extern Volunteer Additional InformationSACRAMENTSIs 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 No Please ExplainHave you celebrated your marriage in the Catholic Church, or otherwise had your marriage recognized in the Church? Yes No Please ExplainGrowing in FaithIs 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 EvangelizationUntitledWho 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 IntentionsBy 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 IntentionsHow 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) NameThis field is for validation purposes and should be left unchanged.
