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Our Lady of Lourdes Parish Registration Form
  1. Family Information
  2. Family Last Name(*)
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  3. Home Address(*)
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  4. City(*)
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  5. State(*)
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  6. Zip Code(*)
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  7. Family Email Address(*)
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  8. Home Phone Number(*)
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  9. Phone Number Listed or Unlisted(*)


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  10. Cell Phone
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  11. The Welcoming Committee would like to call on you and bring you information about the parish in a nice keepsake. Is this Okay?(*)
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  12. Every Other Month names of those registering is announced in the bulletin. Is this Okay(*)
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  13.  
  1. Marital Status
  2. Status(*)
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  3. Date of Marriage
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  4. Married in the Church
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  5. If Not Married in the Church did you get the marriage validated (blessed) by a priest:
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  6. If not married in the Church did you get a dispensation to get married in a place/church other than Catholic Church
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  7.  
  1. Male Information
  2. Man's Name
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  3. Date of Birth
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  4. Religion
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  5. Employer
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  6. Work Number
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  7. Baptized
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  8. Date of Baptism
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  9. First Communion
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  10. Confirmation
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  11.  
  1. Female Information
  2. Female's Name
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  3. Date of Birth
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  4. Religion
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  5. Employer
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  6. Work Number
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  7. Baptized
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  8. Date of Baptism
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  9. First Communion
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  10. Confirmation
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  11.  
  1. First Child
  2. Child's Name
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  3. Date of Birth
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  4. Sex
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  5. Grade in School
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  6. School Attending
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  7. Baptized
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  8. Date of Baptism
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  9. First Communion
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  10. Confirmation
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  11. Second Child
  12. Child's Name
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  13. Date of Birth
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  14. Sex
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  15. Grade in School
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  16. School Attending
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  17. Baptized
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  18. Date of Baptism
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  19. First Communion
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  20. Confirmation
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  21. Third Child
  22. Child's Name
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  23. Date of Birth
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  24. Sex
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  25. Grade in School
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  26. School Attending
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  27. Baptized
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  28. Date of Baptism
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  29. First Communion
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  30. Confirmation
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  31. Fourth Child
  32. Child's Name
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  33. Date of Birth
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  34. Sex
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  35. Grade in School
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  36. School Attending
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  37. Baptized
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  38. Date of Baptism
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  39. First Communion
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  40. Confirmation
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  41. Fifth Child
  42. Child's Name
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  43. Date of Birth
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  44. Sex
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  45. Grade in School
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  46. School Attending
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  47. Baptized
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  48. Date of Baptism
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  49. First Communion
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  50. Confirmation
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  51. Sixth Child
  52. Child's Name
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  53. Date of Birth
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  54. Sex
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  55. Grade in School
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  56. School Attending
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  57. Baptized
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  58. Date of Baptism
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  59. First Communion
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  60. Confirmation
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  61. Invalid Input
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