Parish Registration

Family Name REQUIRED Please fill out this field. Please enter valid data.

Title REQUIRED Please fill out this field.

First Name REQUIRED Please fill out this field. Please enter valid data.

Email Address 1 REQUIRED Please fill out this field. Please enter an email address.

Home Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Cell Phone Number Please enter a phone number.

Work Phone Number Please enter a phone number.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Religion REQUIRED Catholic NonCatholic Please fill out this field.

Marital Status REQUIRED Single Married Divorced Widowed Please fill out this field.

In what area(s) of involvement (if any) were you actively involved in your former parish?

Adult #2

Adult #2 First Name Please enter valid data.

Title

Email Address 2 Please enter an email address.

Adult #2 Date of Birth Please enter valid data.

Adult #2 Gender Male Female

Adult #2 Religion** Catholic NonCatholic

Adult #2 Marital Status Single Married Divorced Widowed

In what area(s) of involvement (if any) was this adult actively involved in your former parish?

** If married to someone not of our faith, we welcome your spouse. Would s/he like to be included as a member of our parish, using both your names in our mailings? Yes No

Below, please list only those dependent children currrently living with you.

Child 1 Please enter valid data.

Date of Birth C1 Please enter valid data.

Gender C1 Male Female

Religion C1 Catholic NonCatholic

Grade # (1-12) C1 Please enter valid data.

Grade (if not 1-12) C1 Please enter valid data.

Child 2 Please enter valid data.

Date of Birth C2 Please enter valid data.

Gender C2 Male Female

Religion C2 Catholic NonCatholic

Grade # (1-12) C2 Please enter valid data.

Grade (if not 1-12) C2 Please enter valid data.

Child 3 Please enter valid data.

Date of Birth C3 Please enter valid data.

Gender C3 Male Female

Religion C3 Catholic NonCatholic

Grade # (1-12) C3 Please enter valid data.

Grade (if not 1-12) C3 Please enter valid data.

Child 4 Please enter valid data.

Date of Birth C4 Please enter valid data.

Gender C4 Male Female

Religion C4 Catholic NonCatholic

Grade # (1-12) C4 Please enter valid data.

Grade (if not 1-12) C4 Please enter valid data.

Child 5 Please enter valid data.

Date of Birth C5 Please enter valid data.

Gender C5 Male Female

Religion C5 Catholic NonCatholic

Grade # (1-12) C5 Please enter valid data.

Grade (if not 1-12) C5 Please enter valid data.

Are you interested in our Faith Formation program(s) for your child(ren)? Yes No

Are there any Other(s) living with you?*** Please enter valid data.

Gender_O Male Female

Religion_O Catholic NonCatholic

Date of Birth_O Please enter valid data.

Email Address_O Please enter an email address.

*** Does the individual(s) wish to be registered as part of your family? Yes No

Former Parish REQUIRED Please fill out this field. Please enter valid data.

Former Parish City and State REQUIRED Please fill out this field. Please enter valid data.

I/we give permission to have our photo publicly displayed at Good Shepherd. REQUIRED Yes No Please fill out this field.

What is (male) your occupation/employer? Please enter valid data.

What is (female) your occupation/employer? Please enter valid data.

What brings you to Good Shepherd?

Please send e-mail regarding (check all that apply): Vital Parish Mailings Adult Ministry & Education Youth Ministry & Education Seasonal Worship Schedule Major Social Events Send All Emails

Parish Registration

Questions?

New Parishioner/Household Registration Form

Adult #2