Member Registration Form

(All information is for Catholic Church census data only and will not be shared with any third parties)

Family Name  Head of Household (HOH) Name



Mailing Address

Street  City  Zip

Physical Address, (if different than above)

Street  City  Zip


Email Address  Secondary Email


Phone Numbers

Primary Number    

Secondary Number   

Names of people residing in the same home

HOH Email  DOB

Name 2  Relationship to HOH  Email


Name 3  Relationship to HOH  Email


Name 4  Relationship to HOH  Email


Name 5  Relationship to HOH  Email


Name 6  Relationship to HOH  Email


In what areas of ministry would you like to be involved?


Currently, we have the following ministries: Bible Studies (Spanish & English), Faith Formation (Sunday School, Teachers, RCIA), Knights of Columbus, Community Outreach Program, Extraordinary Ministers of Holy Communion, Readers, Ushers, Hospitality, Music Ministry, Altar Servers, Youth Alive, Mary's Mantle and the Altar Society.

Please let us know which family members are interested in ministry.  Also, please let us know if there are any ministries you would like to see here!

What are the Talents you like to share with your Parish Community?

What days and hours of the week are best for you to serve?

Would you like to receive offertory envelopes?

 Yes   No