[PDF]registration form - Rackcdn.com4e584af7f69bac47d2e3-316695a08fcd1858cfaafe02ebde1da6.r70.cf5.rackcdn.com/...
0 downloads
74 Views
54KB Size
SJA Member Registration 1.Catholic Head of Household
CONFIDENTIAL
PLEASE PRINT
(Last Name, First, MI)
6. Street Address
2. Maiden Name (if applicable)
7. Date of Birth (mm/dd/yyyy)
(Curr. Date:
3. Title - (circle one)
4. Suffix - (circle one)
Mr.
Ms.
Jr.
III
Mrs.
Dr.
Sr.
IV
Miss 9. City/State/Zip Code
10. Email Address
13. Family Name (for mailing purposes)
Catholic Marriage
Single
Married Remarriage
11. Occupation
17. Language (circle all that apply) English
Spanish
Separated
German
French
Divorced
Other ________________
22. Co-Head of Household Name
Widowed
(Last Name, First, MI)
27. Relationship to Head of Household (check one)
5. Home Phone #
8. Work Phone #
II
14. Mailing Address (if different)
16. Family Status (circle one)
)
12. Cell #
15. City/State/Zip Code
18. Disability
19. Do you receive The Catholic Review?
20. Highest Grade Completed
21. Do you wish to? ($25 a year)
(include degrees)
23. Maiden Name (if applicable)
28. Date of Birth (mm/dd/yyyy)
Spouse
Child
Stepchild
Parent
Step-parent
Grandparent 30. Email Address
24. Title (circle one)
25. Suffix (circle one)
Mr.
Ms.
Jr.
III
Mrs.
Dr.
Sr.
IV
Miss
26. Work Phone #
29. Cell #
II 31. Occupation
32. Disability
Other _______________________ 33. Family Status (circle one) Widowed
34. Language (circle all that apply)
35. Religion (circle one)
36. Highest Grade Completed
English
Spanish
Catholic
(include degrees)
French
Jewish
Catholic Marriage
Single
Married
Separated
German
Remarriage
Divorced
Other ________________
Protestant
Other _______________
Please fill in the information on ALL CHILDREN LIVING AT THE ABOVE ADDRESS. 37. Child Name (Last, First, MI)
38. Date of Birth (mm/dd/yyyy)
39. Gender
40. Religion
41. Status
C=Catholic P=Protestant C=Child
42. Grade
43. School Attending
S=Stepchild
J=Jewish
G=Grandchild
Other (please list)
Other (please specify)
1) 2) 3) 4)
St Joan of Arc Church 222 S. Law St. Aberdeen, MD 21001 410-272-4535 (M-TH 9:00-4:00)
Page 1 of 2
Please fill out the following information for each family member. If you were not baptized Catholic, please enter the information when you were officially received into the Catholic Church 44. Baptism
1. Head of Household 2. Co-Head of Household 3. Child #1
4. Child #2
5. Child #3
6. Child #4
45. 1st Communion
46. Confirmation
47. Marriage
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Date
Date
Date
Date
Parish
Parish
Parish
Parish
City/St
City/St
City/St
City/St
Parish Activities (Please circle those parish activities you are interested in joining.) EVANGELIZATION
LITURGY
CHOIRS
OUTREACH
1. Bereavement
5. Prayer Line
10. Altar Server
14. Lectors
20. Adult
25. Bereavement/Hospitality
2. Evangelization Team
11. Cantor
15. Ushers
21. Contemporary
26. Christmas Baskets
29. FISH
3. Faith Sharing Group
6. Teacher/Catechist - Faith Formation (Grades K-5; 6-8; 9-12; Adult)
12. Eucharistic Minister
16. Greeters
22. Resurrection
27. Martha's Meal
4. Pray - ers
7. Welcoming Newcomers
13. Children's Liturgy
23. Modern Band
28. Ministers of Sick
30. Good Samaritan Food Pantry
St Joan of Arc Church 222 S. Law St. Aberdeen, MD 21001 410-272-4535 (M-TH 9:00-4:00)
Page 2 of 2
