New Parishioner Registration Form

Your Full Name

Street Address:

City, State, Zip

Email:

Phone Number (Home):

Phone Number (Cell):

Phone Number (Work):

Birth Date (Month/Day/Year)

Marital Status:

Church of Marriage

Maiden Name

Religion

Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Spouse's Name (First and Last)

Spouse's Birth Date (Month/Day/Year)

Spouse's Email Address:

Spouse's Phone Number:

Maiden Name

Spouse's Religion

Spouse's Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Name of Child (1)

Gender

Birth Date (Month/Day/Year)

Grade Level

Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Name of Child (2)

Gender

Birth Date (Month/Day/Year)

Grade Level

Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Name of Child (3)

Gender

Birth Date (Month/Day/Year)

Grade Level

Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Name of Child (4)

Gender

Birth Date (Month/Day/Year)

Grade Level

Sacramental Information

Baptized

First Communion

Confirmed

None of the Above

Please List Additional Children's Information Here:

Please note if any members of your family have special needs or require assistance you'd like for us to be aware of:

Other Comments

Giving Preference:

How would you like to receive your annual charitable giving tax statement?

Please note any additional comments or requests here:

New Parishioner Registration Form

241 S. Main St, North Canton OH 44720

330-499-2201