Online Registration

Please answer all questions to the best of your ability. If you do not have some of the required information, please call the rectory office as soon as you are able to obtain the information. Thank you!

Family Information

Family Name: Address:
(P.O. BOX #): City/Town: State:
ZIP Code: Home Phone Number:

Would you like to receive Offertory Envelopes?
Yes
No
Would you like to receive a list of parish organizations for your family to join or volunteer in?
Yes
No
Individual Information
Male:
Last Name: First Name:
Middle Initial: Religion: Birth Date:
Occupation: Employer:
Work Phone: Baptism (date):
Confirmation (date): Marital Status:
Marriage (date): Marriage (place):

Female:
Last Name: First Name:
Maiden Name: Religion: Birth Date:
Occupation: Employer:
Work Phone: Baptism (date):
Confirmation (date):

Children (If any):
Last Name: First Name:
Date of Birth: Baptism (date):
Confirmation (date): Received Eucharist: Grade:
School Name: Other Information:

Last Name: First Name:
Date of Birth: Baptism (date):
Confirmation (date): Received Eucharist: Grade:
School Name: Other Information:

If you have additional children, please list them here. If you have any questions, comments, or concerns, please type them here also. Thank you!
 

Comments:

All completed registration forms are sent directly to the Parish of the Holy Martyrs of North America. They will be processed by our parish secretary and added to our parish directory list. All information above is considered confidential and is only used by our office staff and people authorized by the pastor.