Church Registration Form

General Information
Family Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone Number*
Family Email

Head of Household
First Name*
Middle Name
Last Name*
Maiden Name (if applicable)
Date of Birth*
MM slash DD slash YYYY
Religion*
Practicing*
Level of Education*
Occupation
Employer
Cell Phone Number*
Email
Marital Status*
For Any Previous Marriages, Have You Petitioned For An Annulment?
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- None of the above
Hidden
State of Baptism
Select a ministry in which you may wish to participate:
Organization Committees
- Finance Committee
- Stewardship Committee
- Endowment Committee
- Parish Total Board of Education
- Scotus Board of Education
- Cemetery Board
Fraternal Ministries & Support Groups
- Knights of Columbus
- Ladies of the Lord (LOL)
- Christians Encounter Christ (CEC)
- Vocations Committee
- Catholic Daughters of Americas (CDA)
- Parish Prayer Line
- Boy Scouts
- Cub Scouts
- Jovenes para Christo
Hispanic
- For More Information contact 402-564-7151
Liturgical Ministries
- Altar Servers: Adult/Youth
- Choir/Music Ministry
- Extraordinary Ministers of Holy Communion (EMHC)
- Lector: Adult or Youth
- Sacristan
- Greeters/Ushers
Religious Education & Formation
- Adult Bible Study
- Children's Liturgy of the Word
- Godparent Program
- Religious Education Program
- Young Adult Ministry
- Vacation Bible School
- Rite of Christian Initiation of Adults (RCIA)
- Symbolon
Welcoming/Serving Ministry
- Church Decorators
- Church Cleaners
- 1st Saturday Reparation Devotions
- Funeral Dinners
- Meals on Wheels
- Perpetual Adoration
- Right to Life
- Rosary Leader
- Simon House Thrift Store & Food Pantry
- Spanish Interpreters
- St. Vincent de Paul Conference
- Transportation Facilitator
Parish Office Help
- Office Helper
- Money Counters
- Parish Mailing Helper
Parish Community Activities
- Parish Festival
- Night of Entertainment
- World Marriage Day
- Occupational Talents
If there are any additional ministries in which you may wish to participate, please note that in the Additional Remarks box below.
Additional Remarks

Family Information
Date of Marriage
MM slash DD slash YYYY
Is Present union recognized as valid by the Catholic Church?
If one spouse is Non-Catholic, should their name appear on Church Envelopes?
Would Non-Catholic family members wish to inquire into the Catholic Faith?
Number of Children Other Members*
Please enter a number from 0 to 7.

First Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
Hidden
Level of Education*
School Name*
Grade*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not Applicable

Second Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
Hidden
Level of Education*
School Name*
Grade*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Third Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
School Name*
Grade*
Hidden
Level of Education*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Fourth Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
School Name*
Grade*
Hidden
Level of Education*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Fifth Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
School Name*
Grade*
Hidden
Level of Education*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Sixth Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
School Name*
Grade*
Hidden
Level of Education*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Seventh Child's Information
Child's First Name*
Child's Middle Name
Child's Last Name*
Child's Date of Birth*
MM slash DD slash YYYY
Gender*
School Name*
Grade*
Hidden
Level of Education*
Select All Sacraments Received*
- Baptism
- First Communion
- Confirmation
- Not applicable

Any Additional Comments
Please Add Any Additional Information
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Church Registration

Step 1 of 12

General Information

Head of Household

Select a ministry in which you may wish to participate:

Spouse (if applicable)

Select a ministry in which you may wish to participate:

Family Information

First Child's Information

Second Child's Information

Third Child's Information

Fourth Child's Information

Fifth Child's Information

Sixth Child's Information

Seventh Child's Information

Any Additional Comments