Join Our Parish Family – St. James & Our Lady of the Assumption

Church Registering With*

St. James
Our Lady of the Assumption
St. John the Baptist Chapel

Registering as*

Regular Member(s)
Seasonal Member(s)

Family Last Name*

Primary Address*

Street Address Address Line 2 City State ZIP Code

If Applicable, Seasonal Address

Street Address Address Line 2 City State ZIP Code

Preferred Phone Number*

Unlisted*

Yes
No

Preferred Email Address

Marital Status*

Number of Minors Living at Home*

Please enter a number from 0 to 5.

Only put children who are under 18 years of age or who have not graduated from high school

Head of Household

Name*

Prefix First Last

Birthdate*

Occupation*

List “Student” if applicable

Employer*

if student, list “school”

Work Phone

Cell Phone*

Email

(Future) Spouse

Name*

Prefix First Last

Birthdate*

Occupation

List “Student” if applicable

Employer

if student, list “school”

Work Phone

Cell Phone*

Email

Child 1

First Name*

add the last name if different from family name above

Sex*

Male
Female

Date of Birth*

Name of School*

If not in school, put ‘N/A’

Grade*

Email

Child 2

First Name*

add the last name if different from family name above

Sex*

Male
Female

Date of Birth*

Name of School*

If not in school, put ‘N/A’

Grade*

Email

Child 3

First Name*

add the last name if different from family name above

Sex*

Male
Female

Date of Birth*

Name of School*

If not in school, put ‘N/A’

Grade*

Email

Child 4

First Name*

add the last name if different from family name above

Sex*

Male
Female

Date of Birth*

Name of School*

If not in school, put ‘N/A’

Grade*

Email

Child 5

First Name*

add the last name if different from family name above

Sex*

Male
Female

Date of Birth*

Name of School*

If not in school, put ‘N/A’

Grade*

Email

Thank you for taking the time to complete this form in its entirety. The information you provide here will assist your Parish family in providing various services/ministries to you and your family.

Sacrament Information

Sacrament Dates and Locations*

Please follow the order of Head of Household, Spouse, and then children on separate lines. Filling in those applicable

Additional Information

Please Indicate Reason for Parish Membership*

Former Parishioner
New to Area
RCIA
Parish Transfer

Please List Former Parish*

Did Your Marriage Take Place in a*

Catholic Church
Protestant Church
Civil Ceremony

Church Attendance

Regular
Frequent
Occasional
Seldom

Preferred Offertory Method*

Weekly Envelopes
Online Giving

(Note: Only those using envelopes or electronic giving will receive an annual contribution statement for tax purposes)

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Parish Registration Form

Head of Household

(Future) Spouse

Child 1

Child 2

Child 3

Child 4

Child 5

Sacrament Information

Additional Information