Saint Vincent Pallotti Church Online

Family Information Please print full Family Name and Address in space provided below
Family Name: Registration Date:
Mailing Name:
Street Address:
City/State/Zip:
Check if unlisted:
Home Phone: Second Phone:
Fax: Cell:
Family E-Mail:
Individual Member Registration Please complete a form for each member of the household. Check appropriate choices or print information as requested in the spaces below.
Check one, as approproate:
Head of Household: Spouse: Child: Other Adult:
First Name: Middle Name:
Last Name: Maiden Name:
Birthdate: Birthplace:
Personal Phone: Business Phone:
Individual E-Mail:
Marital Status: Married: Divorced: Sperated: Single: Widowed:
If Married, Marriage Type: Catholice Church: Non-Catholic Ceremony: Civil Ceremony: Date: Place:
If Divorced: Annuled: Annulment Pending: Annulment Denied:
Father's Full Name:
Mother's Full Maiden Name:

Health: Healthy: Ill: Shut In: Disabled: Special Child:
Ethnic: Caucasin: African American: Asian: Hispanic: Filipino: Other:
Religion: Catholic: Baptist: Episcopal: Lutheran: Methodist: Presbyterian: Other:
Mass Attendance: Regular (weekly): Frequent: Occasional: Seldom: Never:
Baptized:
Communion:
Confirmerd:

Occupation:
Place of Employment:
Job Status: Full Time: Part Time: Homemaker: Military: Retired: Student: Unemployed:
Education: Top Grade Level Achieved:

Stewardship of Service: Would you like to become involved in parish life? If so, check all areas of interest.
Collection Counters Finance Council Pastoral Council Altar Linens Altar Servers Art & Environment Eucharist Ministers Greeters & Ushers Lectors Liturgy Preparation Cantors Children's Choir & Chime Choir 9am Mass Choir 11am Mass Choir 7pm Mass/Praise & Worship Instrumentalists Music Ministry Coordinators Baptism Preparation Confirmation Preparation First Eucharist Preparation First Penance Preparation RCIA Catholic School & Pre-School PTA	Bereavement Cathedral Kitchen Faith & Justice Helping Hands Prayer Shawl Family Life Mom's Ministry Youth & Young Adult KOCA Catch the Spirit Children's Liturgy Religious Education Sunday Nursery Women's Prayer Group Men's Prayer Group Prayer Group Alanon & Al-A-Teen Alcoholics Anon. Bible Sharing Boy Scouts Grief Support Group Leisure Club-Seniors Marriage Partners SPC Book Club