EmailMe Form - Our Lady of the Sacred Heart Registration Form

Date Time

MM / DD / YYYY

Family (Last) Name *

(Full Name) Head of Household *

First MI Last Suffix

(Full Name) Spouse *

First MI Last

If single, please write n/a

Spouse's Maiden Name *

If no maiden name, please write n/a

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Phone *

### - ### - ####

Second Phone (if applicable)

### - ### - ####

Title for Mailing Label: *

Marital Status *

If Married: Church & Date of Marriage

Married by Priest or Deacon?

Yes

No

Parish Ministries or Organziations that you would like to participate in:

Please complete for EACH member of the family registering at this time

Head of Household Name *

First MI Last Suffix

Sex *

Male

Female

Birth Date: *

MM / DD / YYYY

Religion *

Baptism Date

MM / DD / YYYY

Church of Baptism

Confirmation Date

MM / DD / YYYY

Church of Confirmation

Occupation; *

Highest Degree/Grade Completed *

Cell Phone

### - ### - ####

Email *

Please complete this section for the Spouse:

Spouse Name

First MI Last Suffix

Sex

Male

Female

Birth Date:

MM / DD / YYYY

Religion

Baptism Date

MM / DD / YYYY

Church of Baptism

Confirmation Date

MM / DD / YYYY

Church of Confirmation

Occupation

Highest Degree/Grade Completed

Cell Phone

### - ### - ####

Email

Please complete this section for Child #1

Child's Name

First Last

Sex

Male

Female

Birth Date:

MM / DD / YYYY

Religion

Baptism Date

MM / DD / YYYY

Church of Baptism

Confirmation Date

MM / DD / YYYY

Church of Confirmation

Occupation or School/Grade

Highest Degree/Grade Completed

Cell Phone

### - ### - ####

Email

Please complete this section for Child #2

Child's Name

First Last

Sex

Male

Female

Birth Date:

MM / DD / YYYY

Religion

Baptism Date

MM / DD / YYYY

Church of Baptism

Confirmation Date

MM / DD / YYYY

Church of Confirmation

Occupation or School/Grade

Highest Degree/Grade Completed

Cell Phone

### - ### - ####

Email

Please complete this section for Child #3

Child's Name

First Last

Sex

Male

Female

Birth Date:

MM / DD / YYYY

Religion

Baptism Date

MM / DD / YYYY

Church of Baptism

Confirmation Date

MM / DD / YYYY

Church of Confirmation

Occupation or School/Grade

Highest Degree/Grade Completed

Cell Phone

### - ### - ####

Email

We would greatly appreciate if you could UPLOAD a Family/Individual Photo

If you have more than 3 children registering, please include their information below.

How would you like to give to the parish? *

I would like to receive weekly envelopes

I would like to give electronically

If you have any comments or questions, please leave them here:

Thank you for completing the registration form. Please do not hesitate in contacting us if you have any questions!

Unique ID