Parish Registration Form -

Family Details

Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Street Address REQUIRED Please fill out this field. Please enter valid data.
Apartment/Unit Number 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.
Housing Area / Subdivision Please enter valid data.

Information of Husband or Single Male

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
Goes by Name Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
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.
Occupation Please enter valid data.
Language Preference Please enter valid data.
Race REQUIRED African American Asian Hispanic White Other Please fill out this field.
Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
Date of Baptism Please enter a date.
Church of Baptism Please enter valid data.
City and State (or Country) of Church where baptized Please enter valid data.
Religion if not Catholic Please enter valid data.

Information of Wife or Single Female

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
Maiden Name (if married) Please enter valid data.
Goes by Name Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
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.
Occupation Please enter valid data.
Language Preference Please enter valid data.
Race REQUIRED African American Asian Hispanic White Other Please fill out this field.
Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
Date of Baptism Please enter a date.
Church of Baptism Please enter valid data.
City and State (or Country) of Church where baptized Please enter valid data.
Religion if not Catholic Please enter valid data.

Marriage Information

Marital Status REQUIRED Single Cohabitating Married Separated Divorced Widowed Please fill out this field.
If Married: Date of Marriage Please enter a date.
Church Married in (Name) Please enter valid data.
Church Name and Location (city/state and country if outside U.S.) Please enter valid data.
Location of Marriage if other than Church Please enter valid data.
Is This Marriage recognized by the Catholic Church? Yes No Unsure

Participation in Mass REQUIRED Weekly Less than twice a month Irregularly Seldom Please fill out this field.

Would you like to receive Offertory Envelopes? REQUIRED Yes No Please fill out this field.

Do you plan on utilizing Online Giving? Yes No

Our Online Giving Site can be accessed on our website by clicking on the Giving tab.

St Elizabeth Ann Seton