Registration Form

Address *

Line 1

Line 2

City

State

Zip Code

Country

Head of Household Name *

First

Last

Date of Birth (Head of Household) *

Sacraments Received *

Baptism First Communion Confirmation

State of Baptism *

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

Name of SPOUSE (If Any) *

Spouse's Cell Phone Number *

Spouse's Sacraments *

Baptism First Communion Confirmation

State of Baptism *

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

Child_1 /Other Member Name *

Gender *

Male Female

Sacraments Received *

Baptism First Communion Confirmation

State of Baptism *

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

Child_2 /Other Member Name *

Gender *

Male Female

Sacraments Received *

Baptism First Communion Confirmation

State of Baptism *

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

Child_3 /Other Member Name *

Gender *

Male Female

Sacraments Received *

Baptism First Communion Confirmation

State of Baptism *

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

Would you like to be added to our email list to receive parish updates and weekly bulletins? (Choose One) *

Yes, I would like to receive emails No, please do not send me emails

We'd love to see you soon!

Church: 1515 W. Benjamin Holt Drive, Stockton, CA 95207
Ministry Center: 6715 Leesburg Place, Stockton, CA 95207
School: 1635 W. Benjamin Holt Drive, Stockton, CA 95207

Ministry Center Hours

M-F: 8:30am-4:30pm

Telephone

209-472-2150

Email

media@presentationchurch.net