User Log On

Registration form Registration form

PhotoPhotoPhotoPhotoPhotoPhotoPhotoPhoto
PhotoPhotoPhotoPhotoPhotoPhotoPhotoPhoto
Photo Photo Photo Photo Photo Photo Photo Photo

St. Brendan on the Lake Faith Community Registration Form

 

FAMILY LAST NAME______________________________________ Mr./ Mrs., Mr., Mrs., Miss, Ms., Dr./Mrs., Dr./Dr

 

ADDRESS________________________________________________ CITY________________________________ ZIP________

 

PHONE #___________________________ UNLISTED (Y) (N) 

 MARITAL STATUS

No. of CHILDREN AT HOME_______ Catholic Church Marriage, Church Marriage, Civil Marriage,

CHURCH ATTENDANCE: REGULAR ___ FREQUENT ___ OCCASIONAL ___ SELDOM___ Single, Widowed, Separated, Divorced

________________________________________________________________________________________________________________________________

 

 

 

HEAD OF HOUSE

SPOUSE

OTHER/CHILD

CHILD

CHILD

CHILD

CHILD

FIRST NAME

 

 

 

 

 

 

 

MAIDEN NAME/LAST NAME IF DIF

 

 

 

 

 

 

 

MARITAL STATUS

 

 

 

 

 

 

 

HANDICAP

 

 

 

 

 

 

 

RELIGION

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

 

 

 

PLACE OF EMPLOYMENT

 

 

 

 

 

 

 

SCHOOL & GRADE

 

 

 

 

 

 

 

SEX (MALE/FEMALE)

M F

M F

M F

M F

M F

M F

M F

DATE OF BIRTH ( MO/DA/YR)

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

BAPTISM (YES/NO)

DATE OF BAPTISM

CHURCH OF BAPTISM

LOCATION

 

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

FIRST COMMUNION (Y/N)

Y N

Y N

Y N

Y N

Y N

Y N

Y N

CONFIRMATION (YES/NO)

DATE

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

Y N

___/___/___

MARRIAGE DATE

 

CHURCH/PLACE OF MARRIAGE

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

___/___/___

AREAS OF INTEREST