Parish Registration Today's Date MM slash DD slash YYYY Type of Registration New Registration Update to Current Registration If you are a current parishioner, what year did you join SJB Parish: Primary Language Household and Family Information Instructions: Please complete all sections listed below.Household Family’s Last Name Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneMy preference for contribution envelopes is Weekly Monthly Electronic giving Family Information (Please include head of the family first and all family members): Family Member #1Name First Middle Last Email Address Date of Birth MM slash DD slash YYYY Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #2Name First Middle Last Email Address Date of Birth MM slash DD slash YYYY Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #3Name First Middle Last Email Address Date of Birth MM slash DD slash YYYY Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #4Name First Middle Last Email Address Date of Birth MM slash DD slash YYYY Date of Birth MM slash DD slash YYYY Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #5Name First Middle Last Email Address Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #5Name First Middle Last Email Address Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced Family Member #6Name First Middle Last Email Address Relationship Self Spouse Child Sacraments Baptized 1st Communion Confirmed Other Religion Specify Other Religion Marital Status Single Married Widowed Separated Divorced EmailThis field is for validation purposes and should be left unchanged.
