NEW PARISHIONER REGISTRATION FORM (Please PRINT) Family Name (last name only): ______________________________________________________________ Mailing Address: __________________________________________________________________________ Number Street (Apt.) City State Zip Home Phone or Primary Phone: ___________________________ FEMALE ________________________________________ ___________________ Maiden: _____________ ________________________________________ ________________________________________ MALE First Name: ______________________________________ Middle Name: ____________________________________ Email Address: ____________________________________ Cell Number: _____________________________________ Date of Birth: _____________________________________ ________________________________________ Religion: _________________________________________ ________________________________________ Marital Status (check one): Single Married Separated Divorced Widow/Widower How did you find out about SCS? _________________________________________________________________ CHILDREN LIVING AT HOME: (Please include this same information on the reverse side for additional children) Full Name: _________________________________________ Date of Birth: _________________________ Gender: __________ Religion: ___________ Relationship: _________________________________ Full Name: _________________________________________ Date of Birth: _________________________ Gender: _________ Religion: ____________ Relationship: _________________________________ Full Name: __________________________________________ Date of Birth: ________________________ Gender: _________ Religion: ____________ Relationship: _________________________________ Full Name: __________________________________________ Date of Birth: ________________________ Gender: _________ Religion: ____________ Relationship: _________________________________ Thank you for registering at St. Catherine of Siena! We welcome you to our parish! Full Name: __________________________________________ Date of Birth: ________________________ Gender: _________ Religion: ____________ Relationship: _________________________________ Completed form may be sent to Parish Office via mail or email to [email protected]