Register Welcome! Please complete this form to register as a parishioner at Old St. Mary’s. Your Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email Address* Home Phone NumberMobile Phone NumberWork Phone NumberAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Birthday Are you Catholic?YesNoSacraments you have received: Baptism First Confession First Holy Communion Confirmation Select all that apply.What is the highest level of education you have received?High SchoolCollegePost GraduateName of Spouse Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Birthday Is your spouse Catholic?YesNoSacraments your spouse has received: Baptism First Confession First Holy Communion Confirmation Select all that apply.What is the highest level of education your spouse has received?High SchoolCollegePost GraduateAre you and your spouse married in the Catholic Church?YesNoDate of Marriage At what other churches do you intend on attending Mass?Which Mass do you and your family predominantly attend?LatinGermanEnglishChoose one.ChildrenDo you and your spouse have children?YesNoHow many children?How are your children receiving religious formation? School Homeschool CCD Other Select all that apply.Name of First Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Second Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Third Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Fourth Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Fifth Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Sixth Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Seventh Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Name of Eighth Child First Last Birthday What sacraments has this child NOT received? Baptism First Confession First Holy Communion Confirmation Select all that apply.Parish Activities and VolunteeringPlease indicate any of the below activities you or your children would like to be involved in at Old St. Mary's: Altar Server Usher Choir RCIA Team Marriage Prep Team Church Cleaning Office Volunteer Maintenance Volunteer Altar Society Vestment Making / Repair Other (please describe in field below) Select all that apply.Please describe the "Other" parish activities that you would like to be involved in:EmailThis field is for validation purposes and should be left unchanged.
