Parish Registration Today's Date Date Format: MM slash DD slash YYYY Type of RegistrationNew RegistrationUpdate to Current RegistrationIf you are a current parishioner, what year did you join SJB Parish:Primary LanguageHousehold and Family Information Instructions: Please complete all sections listed below.Household Family’s Last NameAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneMy preference for contribution envelopes isWeeklyMonthlyElectronic givingFamily Information (Please include head of the family first and all family members): Family Member #1Name First Middle Last Email Address Date of Birth Date Format: MM slash DD slash YYYY RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #2Name First Middle Last Email Address Date of Birth Date Format: MM slash DD slash YYYY RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #3Name First Middle Last Email Address Date of Birth Date Format: MM slash DD slash YYYY RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #4Name First Middle Last Email Address Date of Birth Date Format: MM slash DD slash YYYY Date of Birth Date Format: MM slash DD slash YYYY RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #5Name First Middle Last Email Address RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #5Name First Middle Last Email Address RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedFamily Member #6Name First Middle Last Email Address RelationshipSelfSpouseChildSacraments Baptized 1st Communion Confirmed Other Religion Specify Other ReligionMarital StatusSingleMarriedWidowedSeparatedDivorcedNameThis field is for validation purposes and should be left unchanged.
