Facebook Phone

Register / Registrarse

- New to the parish?
  - Register / Registrarse
  - Interested in becoming Catholic?

Parish Registration Form:
The maximum number of form submissions has been reached. This form is currently not available.
- This is our parish full registration form. Please fill out as much of the form as possible. After filling in the Family Name, please fill out information for each member of the family. If you have any questions, please call the parish office at 740-774-1407. Thank you for your time and welcome!
- FAMILY REGISTRATION INFORMATION / FORMULARIO DE REGISTRO FAMILIAR
  
  Family Name / Apellido REQUIRED Please fill out this field. Please enter valid data.
  
  First Name(s) / Nombre REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Address Line 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Address Line 2 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.
  
  Permission to publish phone, address, email in Parish Directory? / ¿Permiso para publicar teléfono, domicilio, email en el directorio parroquial? REQUIRED Address / Domicilio Email Phone / Teléfono Address and Phone Number Only / Solo domicilio y número de teléfono All / Todo Please fill out this field.
  
  Contribution Type / Tipo de contribución REQUIRED Envelope / Sobre de Ofertorio Online Giving / Dar en línea Please fill out this field.
  
  Marital Status / Estado Civil REQUIRED
  Please choose the best answer of your current status. / Elija la mejor respuesta de su estado actual.
  Single / Único / Única Married / Casado / Casada Divorced / Divorciado / Divorciada Widowed / Viudo / Viuda Separated / Apartado / Apartada Please fill out this field.
- INDIVIDUAL MEMBER INFORMATION / INFORMACION INDIVIDUAL
  
  ADULT MALE / HOMBRE
  
  First Name / Nombre Please enter valid data.
  
  Last Name / Apellido Please enter valid data.
  
  Role / Titular Please enter valid data.
  
  Date of Birth / FDN Please enter a date.
  
  Birthplace / Lugar de nacimiento Please enter valid data.
  
  Special Needs / Necesidades Especiales Please enter valid data.
  
  Catholic? / Católica Yes / Sí No
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo
  fecha de recepción
  Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Reconciliation / Confesión Has received / Ha recibido Has not received / No ha recibido
  
  Confirmation / Confirmación Please enter a date.
  
  ADULT FEMALE / MUJER
  
  First Name / Nombre Please enter valid data.
  
  Last Name / Apellido Please enter valid data.
  
  Maiden Name / Nombre de soltera Please enter valid data.
  
  Role / Titular Please enter valid data.
  
  Date of Birth / FDN Please enter a date.
  
  Birthplace / Lugar de nacimiento Please enter valid data.
  
  Special Needs / Necesidades Especiales Please enter valid data.
  
  Catholic? / Católica Yes / Sí No
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo
  fecha de recepción
  Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión Has received / Ha recibido Has not received / No ha recibido
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
- MARITAL INFORMATION / INFORMACIÓN MARITAL
  
  If currently married please fill out the underlying boxes concerning your marital information. / Si actualmente está casado, complete los recuadros correspondientes a su información matrimonial.
  
  Married by a Priest/Deacon? / ¿Casado por un sacerdote / diácono? Yes / Sí No
  
  Marriage Date / Fecha de Matrimonio Please enter valid data.
  
  Place / Church - Lugar / Iglesia Please enter valid data.
  
  City & State / Ciudad & Estado Please enter valid data.
  
  Celebrant Name / Celebrante Nombre Please enter valid data.
  
  Any previous divorces for either spouse? / ¿Algún divorcio previo de cualquiera de los cónyuges?
  Not applicable if spouse is deceased. / No aplica si el cónyuge ha fallecido.
  Yes / Sí No
- CHILD(REN) INFORMATION / INFORMACIÓN DE LOS HIJOS
- How many children are you registering? / ¿Cuántos niños estás registrando? REQUIRED Please fill out this field.
  
  Child / Hijo 1
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 2
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 3
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 4
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 5
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 6
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 7
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 8
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 9
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 10
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 11
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
  
  Child / Hijo 12
  
  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.
  
  Relationship to Head of Household / Relación con del Titular REQUIRED Please fill out this field. Please enter valid data.
  
  Gender / Sexo REQUIRED Please fill out this field.
  
  Date of Birth / FDN REQUIRED Please fill out this field. Please enter a date.
  
  Birthplace / Lugar Nacimento REQUIRED Please fill out this field. Please enter valid data.
  
  SACRAMENTS / SACRAMENTOS
  
  Baptism / Bautismo Please enter a date.
  
  Church of Baptism / Iglesia del Bautismo Please enter valid data.
  
  City, State, & Country / Ciudad, Estado, País Please enter valid data.
  
  Reconciliation / Confesión REQUIRED Has received / Ha recibido Has not received / No ha recibido Please fill out this field.
  
  First Communion / Sagrada Comunión Please enter a date.
  
  Confirmation / Confirmación Please enter a date.
Submit

Our Lady, queen of the apostles

The Catholic Community in Ross & Pike Counties

Register / Registrarse

Parish Registration Form: