Parish Registration Form HiddenName Family Name* Address Street Address Address Line 2 City State ZIP / Postal Code Mailing Address (if different from Street Address)* Marital StatusSingleEngagedMarriedWidowedSeparatedDivorcedAnnulledIf Married, were you married by a priest? Yes No Date of Marriage Wife's Maiden Name Please check all that apply Retired Homebound Disabled Winter Visitor Head of Household Name (first, middle, last) Sex Male Female SalutationMr.Mrs.MsMissOtherOther Salutation not listed Email* Occupation* Work Phone Cell Phone* Date of Birth* Religion* Sacraments Received* Baptism Confirmation First Communion First Reconciliation Marriage None Spouse's Name (first, middle, last) Sex Male Female SalutationMrMrsMsMissOtherOther Salutation not listed Email Occupation Work Phone Cell Phone Date of Birth Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None TithingTithing Options Electronic Funds (visit faithdirect.net, parish code AZ597) Self Directed Bill Pay (via your bank account) Plate Donation with Family Envelopes (envelopes mailed to you) Plate Donation via Check with ID written on it (without envelope) Please list all other family members in your household below.1) Name (first, middle, last) Sex Male Female Date of Birth Age Enrolled in School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None 2) Name (first, middle, last) Sex Male Female Date of Birth Age Enrolled in School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None 3) Name (first, middle, last) Sex Male Female Date of Birth Age Enrolled in School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None 4) Name (first, middle, last) Sex Male Female Date of Birth Age Attending School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None 5) Name (first, middle, last) Sex Male Female Date of Birth Age Attending School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None 6) Name (first, middle, last) Sex Male Female Date of Birth Age Attending School Yes No Name of School Grade Religion Sacraments Received Baptism Confirmation First Communion First Reconciliation Marriage None Please be sure to check the box below and then click on the Submit button. You will be redirected to a message page if you have successfully submitted your request.
