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Parish Registration

Thanks for taking a moment to register your household's information with our parish office. Please fill out the form as completely as possible and then click submit.

Family's Last Name

Today's Date:

Street Address:

Apt. / Suite #

City:

State

Zip

Mailing Address (If different from Street Address)

Apt./Suite/P.O. Box #

City:

State

Zip

Home Phone

Is phone unlisted?

Yes

No

Free Text

HEAD OF HOUSEHOLD

Prefix:

Last Name

First Name:

MI:

Suffix:

Preferred Name (Nickname):

Mobile Phone:

Work Phone:

Email:

Religion

Gender:

Date of Birth:

Marital Status

Anniversary

Sacraments Received (Check all that apply)

Baptism

First Communion

First Confession

Confirmation

Sacramental Marriage

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SPOUSE

Prefix:

Last Name:

First:

MI:

Maiden Name:

Preferred Name (Nickname):

Suffix:

Mobile Phone:

Work Phone:

Religion

Gender

Date of Birth:

Marital Status

Anniversary:

Sacraments Received (Check all that apply):

Baptism

First Communion

First Confession

Confirmation

Sacramental Marriage

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DEPENDENT 1

Last Name:

First Name:

MI:

Suffix

Preferred Name (Nickname):

Date of Birth:

Relation to Head of Household:

Religion

Gender

School

Grade:

Sacraments Received (Check all that apply):

Baptism

First Confession

First Communion

Confirmation

Free Text

DEPENDENT 2

Last Name:

First Name:

MI:

Suffix

Preferred Name (Nickname)

Date of Birth:

Relation to Head of Household:

Religion:

Gender

School:

Grade:

Sacraments Received:

Baptism

First Confession

First Communion

Confirmation

Free Text

DEPENDENT 3

Last Name:

First Name:

MI:

Suffix

Preferred Name (Nickname):

Date of Birth:

Relation to Head of Household:

Religion:

Gender

School:

Grade:

Sacraments Received:

Baptism

First Confession

First Communion

Confirmation

Free Text

DEPENDENT 4

Last Name:

First Name:

MI:

Suffix:

Preferred Name (Nickname):

Date of Birth:

Relation to Head of Household:

Religion:

Gender

School:

Grade:

Sacraments Received (Check all that apply):

Baptism

First Confession

First Communion

Confirmation

Free Text

DEPENDENT 5

Last Name:

First Name:

MI:

Suffix:

Preferred Name (Nickname):

Date of Birth:

Relation to Head of Household

Religion:

Gender:

School

Grade:

Sacraments Received (Check all that apply):

Baptism

First Confession

First Communion

Confirmation

Thank you for submitting your parishioner registration. We are happy you are here! Please let us know if you have any special needs. May God bless you!

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St. Pius X Catholic Church

5620 Gollihar Rd, Corpus Christi, TX 78412, United States of America

361-993-4053

© St. Pius X Catholic Church

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