New Parishioner Registration Form <div> <span>FORMULARIO DE REGISTRO PARA NUEVOS FELIGRESES</span> <br /> </div>

Type Of Registration / Tipo de Registro REQUIRED Please fill out this field.

Head of Household #1 / Jefe de Hogar #1 REQUIRED Please fill out this field.

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

Last Name / Apellido REQUIRED Please fill out this field. Please enter valid data.

Gender / Sexo REQUIRED Please fill out this field.

Date of Birth / Fecha de Nacimiento REQUIRED

MM/DD/YYYY

Please fill out this field. Please enter a date.

Phone Number / Telefono REQUIRED

Home or Cell (Best way to contact you) / De hogar o celular (Mejor número al que llamar)

Please fill out this field. Please enter a phone number.

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

Head of Household #2 / Jefe de Hogar #2

First Name / Nombre Please enter valid data.

Last Name / Apellido Please enter valid data.

Gender / Sexo

Date of Birth / Fecha de Nacimiento

MM/DD/YYYY

Please enter a date.

Phone Number / Telefono

Home or Cell (Best way to contact you) / De hogar o celular (Mejor número al que llamar)

Please enter a phone number.

Email / Correo Electronico Please enter an email address.

Physical Street Address / Dirección física REQUIRED Please fill out this field. 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.

Marital Status / Estado Matrimonial REQUIRED Please fill out this field.

Family Members / Miembros de Familia REQUIRED

First and Last Name, Date of Birth, Gender / Nombre, Apellido, Fecha de Nacimiento, Sexo

Please fill out this field.

Would you like to receive Offertory Envelopes? / ¿Le gustaría recibir sobres de ofertorio? REQUIRED Please fill out this field.

Previous Parish / Iglesia / Parroquia Previa REQUIRED

Name of Parish, City and State / Nombre de Iglesia, Ciudad y Estado

Please fill out this field. Please enter valid data.

Ministry not listed? Ministerio no en la lista?

If you do not see a ministry listed / Si no ves un ministerio en la lista

Please enter valid data.

Preferred Language / Idioma Preferido REQUIRED Please fill out this field.

St. Anthony Marie de Claret