New Parishioner Registration Form
Family Name Envelope No. Address City State Zip Date Registered
Phone: Unlisted Own or Rent Home:
Title First
Primary Email:
Middle
Maiden Name Date of Birth Gender Religion
Spouse:
Head:
Baptism Date/Place Religion Baptized First Communion Date/Place Confirmation Date/Place
Spouse:
Head:
Cell Phone Work Phone Email Attend Mass
(Regularly / Occasionally / Never )
Spouse:
Head:
Marital Status Date Married Marriage Performed by Church/City Where Married Parish Registered Parish Attend
Spouse:
Head:
Occupation Employer Talents/Skills
Grade Level
Language Ethnicity
Spouse:
Head:
Completed
Others at this address
Last Name, First Name, Middle
First
Comm.
Attend
CCD
School Name
or Employer
Grade EthnicityDate of Birth M/F Relationship Confirm
Baptism
Date
Baptism
Place
Religion
New Parishioner Registration Form (Continued)
If you have preschool children: Do you intend sending them to a Parish School? Yes No
Are there homebound children/adults in the household: Yes No
Does Mass Present a problem for any member of the household?
(ie. transportation, illness, no one to stay with homebound - Explain)
Would it be helpful to have a pastoral contact: Yes No
Is there any other way in which the parish could assist?
(ie. communication call, parish visitor, receive parish bulletin, etc. - Explain)
Have any of your house hold been through the R.C.I.A. Program? Yes No
Are you interested in R.C.I.A.? Yes No
Yes No
Are you or someone in your household interested in Cursillo?
If yes, who?
Yes No
Are you or another member of your household a Cursillesta?
If yes, who?
Emergency contact and phone number:
Name: Phone:
Does your family want to a subscription to the Messenger (our diocesan paper) Yes No
If you have specific skills: Would you be willing to help occasionally? Yes No
Please list any special talents, interests, and or Ministries of you or a member of your household may have?
What I will do for our church:
Christian Education
___
CCD Teacher
___
Children’s
Liturgy of the Word
___
Pre-School Aid/Teacher
___ Vacation Bible School
___ Youth Group
Church Committees
___
Board of Education
___
Finance Council
___
Worship
Fellowship/Social
___ Caring 50+ Club
___ Crafty Ladies
___
Holy Dame Society
___
Holy Name Society
___
Spare Time Parishioner Club
Service/Outreach
___ Parish Nursing/Health Ministry
___ St. Vincent de Paul
___ Shut-in Visitation
___ VITA Volunteer
Worship
___
Eucharistic Minister
___
Hospitality
___
Lector
___
Music: Play/Sing/Coordinate
___
Prayer Group/Hot-line
___
Server
Other: (explain)
1. Complete form.
2. Save document to
your desktop.
3. P
rint finished document
and take to parish office
or email to:
stb@stbarbaraky.org