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If you would like to register with The Church of the Holy Family, please complete and submit the form below:

*Required
Your Information:
Name:*
(title) (first) (mi) (last)
       
Informal Name:  
Maiden Name:  
Address:*  
City:* State:* Zip:*
     
Date of Birth:*   / /      
Email:*
Phone Numbers:   Home: - -      
Cell: - -      
Work: - -      
Occupation:  
Company:  
Religious Affiliation:*  
Sacraments Received: Baptized
Confirmed
First Communion
 
Your Status:*





 
If widowed, please
list someone related:
Name:  
Phone: - -      

If married:
Date: / /      
By:
Place:  
City:  
State/Foreign Country:  

Your Spouse's Information:
Name:
(title) (first) (mi) (maiden name)
       
Informal Name:  
Date of Birth: / /      
Email:
Phone Numbers:   Cell: - -      
Work: - -      
Occupation:  
Company:  
Religious Affiliation:  
Sacraments Received: Baptized
Confirmed
First Communion

Your Dependent Children's Information:
Name (first/middle/last) Birth Date Grade Gender Sacraments
1.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
2.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
3.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
4.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
5.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
6.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
7.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
8.
 

     
/ /
     

 

Baptized
Confirmed
1st Communion
 
Additional Comments/Info:
(200 char max)
 
Type in security number:*

(Enter the number you see in
the image to the right into the
Security Number input box)
  Security Number