New Parishioner Registration – 2022 Please enable JavaScript in your browser to complete this form.Family Last Name *Home or Main Phone Number *Home Address *EmailHead of Household Full NameBirthday *Email *OccupationPlace of EmploymentCell Phone Number *Religion *BaptizedYesNoConfirmedYesNoMarital Status *SingleEngagedMarriedDivorcedWidowedIf you are married, were you married by a Catholic Priest?YesNoDate of MarriageSpouse Full NameMaiden NameBirthdayEmailOccupationPlace of EmploymentCell Phone NumberReligionBaptized YesNoConfirmedYesNoPlease list all Children (under the age of 22) - Full Name, Birth Date, Male/Female, Baptized (date), 1st Eucharist(date), Confirmation(Date)Does anyone in your immediate household have special challenges? YesNoIf yes, please indicate who and their challenges.Previous ParishInclude City and State of parish. Please contact your previous parish to have your name removed from their roster list. Per the Diocese of Lafayette (IN), a family can only be registered at one parish. Parish DirectoryIf you do not want your information to be published in the parish directory, check this box. MessageSubmit
