Registration form
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
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HEAD OF HOUSE |
SPOUSE |
OTHER/CHILD |
CHILD |
CHILD |
CHILD |
CHILD |
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FIRST NAME |
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MAIDEN NAME/LAST NAME IF DIF |
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MARITAL STATUS |
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HANDICAP |
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RELIGION |
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OCCUPATION |
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PLACE OF EMPLOYMENT |
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SCHOOL & GRADE |
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SEX (MALE/FEMALE) |
M F |
M F |
M F |
M F |
M F |
M F |
M F |
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DATE OF BIRTH ( MO/DA/YR) |
___/___/___ |
___/___/___ |
___/___/___ |
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BAPTISM (YES/NO) DATE OF BAPTISM CHURCH OF BAPTISM LOCATION
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Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
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FIRST COMMUNION (Y/N) |
Y N |
Y N |
Y N |
Y N |
Y N |
Y N |
Y N |
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CONFIRMATION (YES/NO) DATE |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
Y N ___/___/___ |
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MARRIAGE DATE
CHURCH/PLACE OF MARRIAGE |
___/___/___ |
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AREAS OF INTEREST |
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