Registration Form

Church of the Presentation of the Blessed Virgin Mary

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Registration form

* Indicates required field

Family Last Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Email *

Head of Household Name *

First

Last

Date of Birth (Head of Household) *

Religion *

Marital Status *

Occupation *

Cell Phone Number *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

City of Baptism *

State of Baptism *

Select the state or if out of the country "Not in the U.S.A. and fill in the city and country in the next field box.

City and Country (If not in the U.S.A.) *

Name of SPOUSE (If Any) *

Date of Birth *

Religion *

Marital Status *

Occupation *

Spouse's Cell Phone Number *

Spouse's Sacraments *

Baptism First Communion Confirmation

Church of Baptism *

City of Baptism *

State of Baptism *

Select the state or select "Not in the U.S.A. and fill in the city and country in the next field box.

City and Country (If not in the U.S.A.) *

Child_1 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Select the state or "Not in the U.S.A. and fill in the city and country in the next field box.

City and Country (If not in the U.S.A.) *

Child_2 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Select the state or "Not in the U.S.A. and fill in the city and country in the next field box.

City and Country (If not in the U.S.A.) *

Child_3 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Select the state or "Not in the U.S.A. and fill in the city and country in the next field box.

City and Country (If not in the U.S.A.) *

Ministry Interest (Required) *

Altar Server Catechetic Eucharist Minister Hospitality Lector Music Parish School RCIA Youth Ministry Other

Submit

Home
- All Are Welcome >
Sacraments
Ministries
Communication
Stewardship
Community
- Comunidad Hispano
- Filipino Community
Media Gallery
- Photos
- Videos