Parish Registration Form – St. George Roman Catholic Church

General Information

Today's Date:*

Family Last Name:*

Have you been a member of a parish previously?*

If yes, where?

How would you like your mail to be addressed?

Male Head of Household Name

First Last

Female Head of Household Name

First Last

Home Address*

Street Address Address Line 2 City State ZIP Code

Do you have children living in your household?*

Child One: Name, Age and Grade

Child Two: Name, Age and Grade

Child Three: Name, Age and Grade

Child Four: Name, Age and Grade

Please add any additional children with name, age and grade.

Preferred 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.

Primary Home Phone*

Male Cell Phone

Female Cell Phone

Other Cell Phone

Would you like to receive weekly church contribution envelopes?*

Would you like to receive information about Automatic Offertory Withdrawal?*