Parish Registration Page Please enable JavaScript in your browser to complete this form.Your DetailsName *FirstMiddleLastEmail *PhoneBirthdateSpouse DetailsSpouse's Name *FirstMiddleLastSpouse's Email *Spouse's PhoneSpouse's BirthdateMarriage AnniversaryAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWere you previously registered in another parish? YesNoIf yes, please name the parish:Do we have permission to publish your home number within the parish?YesNoPlease selectOnline GivingParish EnvelopesAre you a full time resident? YesNoIf no, months at local residence:Head 1 *FirstLastReligionBirthday (mm/dd/yyyy)GenderMaleFemaleOccupationGrade/SchoolPersonal StatusMarriage Catholic (recognized by church)Marriage OtherSingleEthnicity AsianBlackHispanicNative AmericanWhiteOther (please specify)LanguageEnglishSpanishCreoleVietnameseKoreanTagalogOther (please specify)Sacraments received (Check all that apply)Baptism1st Communion ConfirmationMarriageHead 2FirstLastReligionBirthday (mm/dd/yyyy)GenderMaleFemaleOccupationGrade/SchoolPersonal StatusMarriage Catholic (recognized by church)Marriage OtherSingleEthnicity AsianBlackHispanicNative AmericanWhiteOther (please specify)LanguageEnglishSpanishCreoleVietnameseKoreanTagalogOther (please specify)Sacraments received (Check all that apply)Baptism1st Communion ConfirmationMarriageOther Adult/ChildFirstLastReligionBirthday (mm/dd/yyyy)GenderMaleFemaleOccupationGrade/SchoolPersonal StatusMarriage Catholic (recognized by church)Marriage OtherSingleEthnicity AsianBlackHispanic Native American WhiteOther (please specify)LanguageEnglishSpanishCreoleVietnameseKoreanTagalogOther (please specify)Other Adult/ChildFirstLastReligionBirthday (mm/dd/yyyy)GenderMaleFemaleOccupationGrade/SchoolPersonal StatusMarriage Catholic (recognized by church)Marriage OtherSingleEthnicity Asian BlackHispanic Native American WhiteOther (please specify)LanguageEnglish SpanishCreoleVietnameseKoreanTagalogOther (please specify)Sacraments received (Check all that apply)Baptism1st Communion ConfirmationMarriageOther Adult/ChildFirstLastReligionBirthday (mm/dd/yyyy)Gender MaleFemaleOccupationGrade/SchoolPersonal StatusMarriage Catholic (recognized by church)Marriage OtherSingleEthnicity AsianBlackHispanicNative American WhiteOther (please specify)LanguageEnglishSpanishCreoleVietnameseKoreanTagalogOther (please specify)SacramentsBaptism1st Communion ConfirmationMarriageAny special needs, circumstances, or information of which the parish should be aware? For Office Use OnlyeGiver NumberParish Envelope NumberCatholic VirginianYesNoSubmit You may also download a printable PDF of this form by clicking hereand email it to office.1@stthersglo.org