Parish Registration

Thank you for taking the time to officially register with Our Lady's Parish. We are pleased to welcome you to our parish community. Please fill out the form as completely as possible and then click submit. If you should have any questions, please don't hesitate to contact the Parish Office.

Thank You and God Bless

Contact Information

Last Name

Address

Street 1*

Street 2

City*

State*

Zip*

Please write in full address; city, state and zip code

Primary Phone

Required* --

Secondary Phone

Email Address

Required*

General Information

First Name

First Name*

Last Name*

Last Name - If different than family last name

First Name

Last Name

Date of Birth

Occupation

Religion

Marital Status

Spouse First Name (with Maiden Name if Married)

First Name

Last Name

Date of Birth

Occupation

Religion

Persons in Household

Aside from people mentioned above, please list all persons living at above address.

Name

First Name

Last Name

Date of Birth

Name

First Name

Last Name

Date of Birth

Name

First Name

Last Name

Date of Birth

Contributions

Please Choose One:	Required*

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