Parishioner Registration | St. Teresa Catholic Church

Title

First Name *

Middle Name

Last Name *

Nickname

Email *

St. Teresa has permission to email me *

Street Address *

City *

State *

Zip Code *

Home Phone *

Mobile Phone *

St. Teresa has permission to text me holy day reminders and other important info

Gender *

Male Female

Marital Status *

Religion *

Occupation *

Employer *

Preferred Language *

Languages Spoken *

Have you received the Sacrament of Baptism? *

Yes No

Baptism Date

Have you received First Communion? *

Yes No

First Communion Date

Have you made your First Reconciliation (Confession)? *

Yes No

First Reconciliation Date

Have you received the Sacrament of Confirmation?

Yes No

Confirmation Date

Children

Do you have children? *

Yes No

Number of Children

Child 1 First Name

Child 1 Last Name

Child 1 Baptism Date

Child 2 First Name

Child 2 Last Name

Child 2 Baptism Date

Child 3 First Name

Child 3 Last Name

Child 3 Baptism Date

Child 4 First Name

Child 4 Last Name

Child 4 Baptism Date

Child 5 First Name

Child 5 Last Name

Child 5 Baptism Date