Parish Registration Form


St. Maximilian Kolbe Parish Registration Form

Welcome to our church! If you are new to the area, moved across town or simply have not registered yet, please complete the form below.

If you have more family members than the form will allow please contact the parish office after completing the registration to add the family member.
 
I would like to:
Register as a New Parishioner
Update My Information on File

Family Name:


email address:                                                                    Telephone number:                                                 Cell phone number:
            

Address1:  

Address2:  

          City:     State:    Zip:  
Head of Household

First Name: Last Name: Occupation:
email: Religion: Birth Date:              Gender:
       

Sacraments:

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Marriage Information
Marital Status: Date of Marriage Location of Marriage

Spouse

First Name: Last Name: Occupation:
email: Religion: Birth Date:              Gender:
       

Sacraments:

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #1

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #2

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #3

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #4

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #5

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:


Family Member #6

First Name: Last Name: School:                                     Grade:
  
email: Religion: Birth Date:              Gender:
       

Sacraments:

               

 

    Baptism     Date: 1st Communion  Date:         Confirmation    Date:




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