ST MICHAEL CATHOLIC CHURCH
PARISH REGISTRATION FORM

FAMILY NAME___________________ REGISTRATION/CENSUS DATE________________

FIRST NAME & INITIAL _____________________________________________________

SPOUSES FIRST NAME & INITIAL (MAIDEN NAME)
_________________________________________________________________________

HOME ADDRESS CITY/TOWN ZIP CODE
______________________________________________________________________

MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
______________________________________________________________________

EMAIL ADDRESS ___________________________________

TELEPHONE NUMBER ___________________________________

COUNTY ___________________________________

YEARS LIVING HERE ___________________________________

MOVED FROM ________________________

HUSBAND'S PLACE OF EMPLOYMENT/OCCUPATION-PHONE
_____________________________________________________________________________

WIFE'S PLACE OF EMPLOYMENT/OCCUPATION-PHONE
_____________________________________________________________________________

MARRIED___ SINGLE___ WIDOWED__ SEPARATED__ DIVORCED___ REMARRIED____

NAME OF FAMILY MEMBER __________  __________  __________  __________

SEX                                               __________  __________  __________  __________

AGE                                              __________  __________  __________  __________

BIRTH DATE                              __________  __________  __________  __________

RELIGION                                   __________  __________  __________  __________

BAPTISM                                   __________  __________  __________  __________

FIRST COMMUNION               __________  __________  __________  __________

CONFIRMAT ION                    __________  __________  __________  __________

SCHOOL GRADE/                     __________  __________  __________  __________

DEGREE                                      __________  __________  __________  __________

HEAD OF HOUSEHOLD         ______________________________________

SPOUSE                                     ______________________________________

OTHERS IN HOME                  ______________________________________