Saint George Parish Registration EmailThis field is for validation purposes and should be left unchanged.General InformationToday's Date:* MM slash DD slash YYYY Have you been a member of a parish previously?* Yes No If yes, where?Family InformationFamily Last Name:*How would you like your mail to be addressed?* Mr. & Mrs. Mr. Mrs. Ms. Miss Other (please specify) Date of marriage, if applicable: MM slash DD slash YYYY Were you married by a Catholic Priest or Deacon? If so, where?Male Head of HouseholdMale Head of Household Name First Last Male Date of Birth MM slash DD slash YYYY Male Cell PhoneMale Email* Enter Email Confirm Email Please include the email that you would like Saint George to use for sending notifications and information to your family.Males Religion*Sacraments Male Has Received?*Baptism?First Reconciliaton?First Holy Communion?Confirmation? Female Head of HouseholdFemale Head of Household Name First Last Female Date of Birth MM slash DD slash YYYY Female Cell PhoneFemale Email* Enter Email Confirm Email Please include the email that you would like Saint George to use for sending notifications and information to your family.Females Religion*Sacraments Female Has Received?*Baptism?First Reconciliaton?First Holy Communion?Confirmation? Contact InformationHome Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Home Phone*Minor Children in HouseholdDo you have children living in your household?* Yes No Please list all minor children in your household below, along with their date of birth.Sacraments Child #1 Has Received?Baptism?First Reconciliaton?First Holy Communion?Confirmation? Sacraments Child #2 Has Received?Baptism?First Reconciliaton?First Holy Communion?Confirmation? Sacraments Child #3 Has Received?Baptism?First Reconciliaton?First Holy Communion?Confirmation? Sacraments Child #4 Has Received?Baptism?First Reconciliaton?First Holy Communion?Confirmation? Would you like to receive weekly church contribution envelopes?* Yes No Would you like to receive information about Automatic Offertory Withdrawal?* Yes No
