Registration Form

: St. Elizabeth Ann Seton Catholic Church Parishioner Registration Form
: Family Details
Family Last Name
Home Phone Number (xxx-xxx-xxxx)
Street Address
Apartment/Unit Number
City & State
Zip Code
Housing Area / Subdivision

: Information of Husband or Single Male
Last Name
First Name
Middle Name
Goes by Name
Date of Birth (mm/dd/yyyy)
Cell Phone Number (xxx-xxx-xxxx)
Email Address
Occupation
Language Preference
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy)
Church of Baptism
City and State (or Country) of Church where baptized
Religion if not Catholic

: Marriage Information
Marital Status: SingleCohabitatingMarriedSeparatedDivorcedWidowed
If Married: Date of Marriage (mm/dd/yyyy)
Church Name
Church Name and Location (city/state and country if outside U.S.)
Location of Marriage if other than Church
Is This Marriage recognized by the Catholic Church?: YesNoUnsure

: Information of Wife or Single Female
Last Name
First Name
Middle Name
Maiden Name (if married)
Goes by Name
Date of Birth (mm/dd/yyyy)
Cell Phone Number (xxx-xxx-xxxx)
Email Address
Occupation
Language Preference
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy)
Church of Baptism
City and State (or Country) of Church where baptized
Religion if not Catholic

Participation in Mass: WeeklyLess than twice a monthIrregularlySeldom
Would you like to receive Offertory Envelopes?: YesNo
Do you plan on utilizing Online Giving?: YesNo
: Our Online Giving Site can be accessed on our website by clicking on the Giving tab.

: Children Living in the household
Last Name - Child 1
First name
Middle Name
Date of Birth (mm/dd/yyyy)
Language Preference
Sex of Child: MaleFemale
Race: African AmericanAsianHispanicWhiteOther
Sacraments received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy) if applicable
Church of Baptism
City and State (or Country) of Church where baptized

Last Name - Child 2
First Name
Middle Name
Date of Birth (mm/dd/yyyy)
Language Preference
Sex of Child: MaleFemale
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy) if applicable
Church of Baptism
City and State (or Country) of Church where baptized

Last Name - Child 3
First Name
Middle Name
Date of Birth (mm/dd/yyyy)
Language Preference
Sex of Child: MaleFemale
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy) if applicable
Church of Baptism
City and State (or Country) of Church where baptized

Last Name - Child 4
First Name
Middle Name
Date of Birth (mm/dd/yyyy)
Language Preference
Sex of Child: MaleFemale
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst CommunionConfirmation
Date of Baptism (mm/dd/yyyy) if applicable
Church of Baptism
City and State (or Country) of Church where baptized

Last Name - Child 5
First Name
Middle Name
Date of Birth (mm/dd/yyyy)
Language Preferred
Sex of Child: MaleFemale
Race: African AmericanAsianHispanicWhiteOther
Sacraments Received: BaptismFirst EucharistConfirmation
Date of Baptism (mm/dd/yyyy) if applicable
Church of Baptism
City and State (or Country) of Church where baptized

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Registration Form

St. Elizabeth Ann Seton Catholic Church Parishioner Registration Form

Information of Husband or Single Male

Marriage Information

Information of Wife or Single Female

Children Living in the household

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