Wednesday, August 15, 2018 at 1:40 PM
Assumption BVM Mass (Aug. 15) 8 am (English) 6:30 pm (Extraordinary Form/Latin)

Parishioner Registration Form

Welcome to St. John the Baptist Catholic Church.   We are happy you have decided to join us.   We invite you to fill out the following registration.   If you choose to receive envelopes for your contributions, you should receive them within the next 60 days.  

Head of Household
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
 Please describe if this person has any special needs (including illnesses)
Birth Date //
  •  
Birth Place
  •  
Country
  •  
E-mail Address
  •  
Religion
  •  
Primary Language Spoken
  •  
Ethnicity
  •  
Marital Status
  •  
Phone -- ext
  •  
Phone -- ext
  •  
Phone -- ext
  •  
Sacraments Completed
  •  
 Please indicated which Sacraments you have received in the Catholic Church
Household Address
Address
  •  
Contribution Envelopes
  •  
Primary Phone Number -- ext
  •  
Spouse/Other Adult
Role
  •  
 Indicate relationship to the head of household
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Birth Date //
  •  
Birth Place
  •  
Country
  •  
E-mail
  •  
Religion
  •  
Primary Language Spoken
  •  
Ethnicity
  •  
Marital Status
  •  
Phone -- ext
  •  
Phone -- ext
  •  
Phone -- ext
  •  
Sacraments Completed
  •  
Dependent #1
Children or adults living in the household
Role
  •  
 Please indicate relationship to Head of Household
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
 Please describe if this person has any special needs (including illnesses)
Birth Date //
  •  
Birth Place
  •  
Country
  •  
Father
  •  
Mother
  •  
Mother's Maiden Name
  •  
Religion
  •  
Primary Language Spoken
  •  
School/College/Unversity
  •  
Sacraments Completed
  •  
Dependent #2
Children or adults living in the household
Role
  •  
 Please indicate relationship to Head of Household
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
Birth Date //
  •  
Birth Place
  •  
Country
  •  
Father
  •  
Mother
  •  
Mother's Maiden Name
  •  
Religion
  •  
Primary Language Spoken
  •  
School/College/Unversity
  •  
Sacraments Completed
  •  
Dependent #3
Child or adult living in the household
Role
  •  
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
Birth Date //
  •  
Birth Place
  •  
Country
  •  
Father
  •  
Mother
  •  
Mother's Maiden Name
  •  
Religion
  •  
Primary Language Spoken
  •  
School/College/Unversity
  •  
Sacraments Completed
  •  
Dependent #4
Child or adult living in the household
Role
  •  
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
 Please describe if this person has any special needs (including illness)
Birth Date //
  •  
Birth Place
  •  
Country
  •  
Father
  •  
 If different from above name
Mother
  •  
Mother's Maiden Name
  •  
Religion
  •  
Primary Language Spoken
  •  
School/College/University
  •  
Sacraments Completed
  •  
Dependent #5
Role
  •  
 Please indicate relationship to Head of Household
Name
  •  
Suffix
  •  
Nick Name
  •  
Gender
  •  
Special Needs
  •  
Birth Date //
  •  
Birth Place
  •  
Country
  •  
Father
  •  
Mother
  •  
Mother's Maiden Name
  •  
Religion
  •  
Primary Language Spoken
  •  
School/College/University
  •  
Sacraments Completed
  •  
 
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