Parish Registration

Parish Registration form printable (Click here)

Registration for St. Mary's Oskaloosa

Date
MM slash DD slash YYYY
Family Name
Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
HEAD of HOUSEHOLD
First Name ___________________________________
Birthday
MM slash DD slash YYYY
Primary Phone
Cell Phone
Email
Baptized ________________________ Confirmed__________________
Occupation / Employer
Spouse
Catholic First Last Maiden Date of Marriage
Birthday
MM slash DD slash YYYY
Cell Phone
Email
Baptized ________________________ Confirmed__________________
Occupation / Employer
CHILDREN and DEPENDENTS
Name ____________________________________Birthday ______________ Male Female
Catholic Date of Baptism Church and City of Baptism First Communion Confirmation
Name _________________________________Birthday __________________ Male Female
Catholic Date of Baptism Church and City of Baptism First Communion
Name ___________________________________________________ Male Female
Catholic Date of Baptism Church and City of Baptism First Communion
Name _____________________________Birthday ______________________ Male Female
Catholic Date of Baptism Church and City of Baptism First Communion
Special Requests or Needs
Consent
I agree to the privacy policy.
We are committed to protecting your privacy. The information you provide may be used for a variety of purposes including the provisions of pastoral services, maintaining and developing our Parish infrastructure and communicating with you on what is happening within our parish and diocesan community.
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Date
MM slash DD slash YYYY
Email
This field is for validation purposes and should be left unchanged.