Parish Registration Form Church Registering With*St. JamesOur Lady of the AssumptionSt. John the Baptist ChapelRegistering as*Regular Member(s)Seasonal Member(s)Family Last Name*Primary Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code If Applicable, Seasonal Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Phone Number*Unlisted*YesNoPreferred Email Address Marital Status*SingleEngagedMarriedWidowedSeparatedDivorcedNumber 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 schoolHead of HouseholdName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Birthdate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Occupation*List "Student" if applicableEmployer*if student, list "school"Work PhoneCell Phone*Email (Future) SpouseName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Birthdate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920OccupationList "Student" if applicableEmployerif student, list "school"Work PhoneCell Phone*Email Child 1First Name*add the last name if different from family name aboveSex*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of School*If not in school, put 'N/A'Grade*No GradePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthTenthEleventhTwelfthEmail Child 2First Name*add the last name if different from family name aboveSex*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of School*If not in school, put 'N/A'Grade*No GradePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthTenthEleventhTwelfthEmail Child 3First Name*add the last name if different from family name aboveSex*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of School*If not in school, put 'N/A'Grade*No GradePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthTenthEleventhTwelfthEmail Child 4First Name*add the last name if different from family name aboveSex*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of School*If not in school, put 'N/A'Grade*No GradePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthTenthEleventhTwelfthEmail Child 5First Name*add the last name if different from family name aboveSex*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of School*If not in school, put 'N/A'Grade*No GradePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthTenthEleventhTwelfthEmail 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 InformationSacrament Dates and Locations*Please follow the order of Head of Household, Spouse, and then children on separate lines. Filling in those applicableAdditional InformationPlease Indicate Reason for Parish Membership*Former ParishionerNew to AreaRCIAParish TransferPlease List Former Parish*Did Your Marriage Take Place in a*Catholic ChurchProtestant ChurchCivil CeremonyChurch AttendanceRegularFrequentOccasionalSeldomPreferred Offertory Method*Weekly EnvelopesOnline Giving(Note: Only those using envelopes or electronic giving will receive an annual contribution statement for tax purposes)CAPTCHA