Parish Registration - San Jose Catholic Church

Date*

Today’s Date

Name*

First Last

Date of Birth*

Please enter your date of birth

Address – include Apt. Number*

Street Address Address Line 2 City State ZIP Code

Cell Phone*

Email*

Enter Email Confirm Email

Marital Status (check one):

Religion

Sacraments Received

Please mark all received Sacraments

Select All
Baptism
Reconciliation
First Communion
Confirmation

Family Info

Spouse Name

Spouse First Name Spouse Last Name

Spouse Phone

Spouse Date of Birth

Spouse Religion

Spouse Received Sacraments

Select All
Baptism
Reconciliation
First Communion
Confirmation

Dependent Child 1 Name

Dependent Child 1 First Name Dependent Child 1 Last Name

Dependent Child 1 Date of Birth

Dependent Child 1 Gender

Male
Female

Dependent Child 1 Sacraments Received

Please indicate all Sacraments your child has already received

Baptism
First Reconciliation
First Communion
Confirmation

Dependent Child 2 Name

Dependent Child 2 First Name Dependent Child 2 Last Name

Dependent Child 2 Date of Birth

Dependent Child 2 Gender

Male
Female

Dependent Child 2 Sacraments Received

Please indicate all Sacraments your child has already received

Baptism
First Reconciliation
First Communion
Confirmation

Dependent Child 3 Name

Dependent Child 3 First Name Dependent Child 3 Last Name

Dependent Child 3 Date of Birth

Dependent Child 3 Gender

Male
Female

Dependent Child 3 Sacraments Received

Please indicate all Sacraments your child has already received

Baptism
First Reconciliation
First Communion
Confirmation

Dependent Child 4 Name

Dependent Child 4 First Name Dependent Child 4 Last Name

Dependent Child 4 Date of Birth

Dependent Child 4 Gender

Male
Female

Dependent Child 4 Sacraments Received

Please indicate all Sacraments your child has already received

Baptism
First Reconciliation
First Communion
Confirmation