New Member Registration

Head of Family:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Middle Initial Please enter valid data.

Maiden Name Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Religious Affiliation if other than Catholic Please enter valid data.

Home Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone Number Please enter a phone number.

Cell Phone Number Please enter a phone number.

Email Please enter an email address.

Marriage Date Please enter a date.

If Catholic, please check the sacraments you have received: Baptism First Communion Reconciliation Confirmation

Spouse:

First Name Please enter valid data.

Last Name Please enter valid data.

Middle Initial Please enter valid data.

Maiden Name Please enter valid data.

Date of Birth Please enter a date.

Religious Affiliation if other than Catholic Please enter valid data.

Home Address Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Home Phone Number Please enter a phone number.

Cell Phone Number Please enter a phone number.

Email Please enter an email address.

If Catholic, please check the sacraments you have received: Baptism First Communion Reconciliation Confirmation

Children: (Children over 21 and/or not living at home should register themselves.)

Sacramental Needs:

Please check what you would like information on: Baptism First Communion Reconciliation Confirmation Holy Orders Marriage Convalidation/Annulment Anointing of the Sick

Catholic Educational and Formational Programming:

Please check what you would like information on: St. John Paul II School (K-8) St. John Paul II Preschool and Daycare Children's Ministry (0-Pre-K) Children's Ministry (Grades K-5) Middle School Ministry (Grades 6-8) High School Ministry (Grades 9-12) College Ministry (18-22) Young Adult Ministry (23-39) Adult Ministry (40 and up)

Is there anyone in the parish that you know? If so who? Please enter valid data.

Please let us know your preferred mode of communications: Email Text Phone