Registration

Registration Type REQUIRED

If you are registering for the first time, select New. If you are updating an existing registration, select Update and supply your envelope number, if known.

New Update Please fill out this field.

Envelope Number (for registration update)

If you are updating an existing registration, please provide your current envelope number, if known. Otherwise, leave blank.

Please enter an integer (number) from 0 to 10000.

Address Line 1 REQUIRED Please fill out this field. Please enter valid data.

Address Line 2 Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Telephones REQUIRED
You can supply up to 4 phone numbers. Enter the number here.
Please fill out this field.
Phone 1
- Phone Type REQUIRED Please fill out this field.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Phone 2
- Phone Type REQUIRED Please fill out this field.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Phone 3
- Phone Type REQUIRED Please fill out this field.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Phone 4
- Phone Type REQUIRED Please fill out this field.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Emergency Contact Phone Number

Number to contact in case of emergency.

Please enter a phone number.

Head of Household

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
Religion REQUIRED Please fill out this field. Please enter valid data.
Occupation REQUIRED Please fill out this field. Please enter valid data.
Sacraments Made(Check all that apply) Baptism 1st Communion Confirmation

Spouse

Were you married by a priest? REQUIRED Yes No Please fill out this field.
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name REQUIRED
Last Name before being married.
Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
Religion REQUIRED Please fill out this field. Please enter valid data.
Occupation REQUIRED Please fill out this field. Please enter valid data.
Sacraments Made(Check all that apply) Baptism 1st Communion Confirmation

Children

Additional information for the Pastor

Christ Our Savior Parish

"Love Grows Here"

Registration