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Parishioner Registration Form

Family Information
Date //
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Family Last Name
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Family Phone --
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Email
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Home Address
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Mailing Address
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If different from home address
Head of Household
When filling out this information, much of the information is a required field. We use this information for identification for sacramental purposes.
Title
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Full Legal Name
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As on Birth Certificate
Suffix
  •  
Nickname
  •  
E-mail
  •  
Cell Phone --
  •  
Work Phone -- ext
  •  
Occupation
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Date of Birth //
  •  
Place of Birth
  •  
Gender
  •  
Ethnicity
  •  
Religion
  •  
Sacraments Received
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Marital Status
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Maiden Name
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Church Marriage Date //
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If married in the Catholic Church or your marriage is recognized by the Catholic Church
Civil Marriage Date //
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If no spouse or dependants scroll down to the Ministries Section.
Spouse
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate or Marriage License
Suffix
  •  
Nickname
  •  
E-mail
  •  
Cell Phone --
  •  
Work Phone -- ext
  •  
Occupation
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Religion
  •  
Sacraments Received
  •  
Marital Status
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Maiden Name
  •  
Ethnicity
  •  
Dependants
A dependant is a child/grandchild under the age of 18 living in your household. However, this can also be a family member such as a parent in your household under your care. If your children are over 18, whether living with you or on their own, they should register as a separate family.
If no dependants skip to the bottom to the Ministries section.
Dependant #1
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate
Suffix
  •  
Nickname
  •  
Relationship to Head of Household
  •  
E-mail
  •  
Cell Phone --
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Maiden Name
  •  
Birth Father's Legal Name
  •  
Birth Mother's Legal Name (Maiden)
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Religion
  •  
Sacraments Received
  •  
Ethnicity
  •  
Dependant #2
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate
Suffix
  •  
Nickname
  •  
Relationship to Head of Household
  •  
E-mail
  •  
Cell Phone --
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Maiden Name
  •  
Birth Father's Legal Name
  •  
Birth Mother's Legal Name (Maiden)
  •  
Religion
  •  
Sacraments Received
  •  
Ethnicity
  •  
Dependant #3
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate
Suffix
  •  
Nickname
  •  
Relationship to Head of Household
  •  
E-mail
  •  
Cell Phone --
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Maiden Name
  •  
Birth Father's Legal Name
  •  
Birth Mother's Legal Name (Maiden)
  •  
Religion
  •  
Sacraments Received
  •  
Ethnicity
  •  
Dependant #4
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate
Suffix
  •  
Nickname
  •  
Relationship to Head of Household
  •  
E-mail
  •  
Cell Phone --
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Maiden Name
  •  
Birth Father's Legal Name
  •  
Birth Mother's Legal Name (Maiden)
  •  
Religion
  •  
Sacraments Received
  •  
Ethnicity
  •  
Dependant #5
We use this information for identification for sacramental purposes. Please fill out as much as possible.
Title
  •  
Full Legal Name
  •  
As on Birth Certificate
Suffix
  •  
Nickname
  •  
Relationship to Head of Household
  •  
E-mail
  •  
Cell Phone --
  •  
Gender
  •  
Date of Birth //
  •  
Place of Birth
  •  
Maiden Name
  •  
Father's Legal Name
  •  
Mother's Legal Name (Maiden)
  •  
Religion
  •  
Sacraments Received
  •  
Ethnicity
  •  
Ministries
Our parish offers a wide variety of ministries all of your spiritual needs. Choose the ministries you and/or your family are interested in participating in.
Ministries
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Select as many ministries as you would like
Electronic Signature
I understand that by becoming a member of the St. Patrick Community, I am called to: (1) Attend Mass Regularly at this parish. (2) Use my Sunday collection envelopes or contribute Online. (3) Support the Ministries of my parish.
Electronic Signature
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Online Giving If you would like more information on Online Giving, please click on the Online Giving Icon at the bottom of the home page or the Online Giving Tab at the top of this page. If you have any questions about Online Giving that cannot be answered on this website, please feel free to call the office at 361-855-7351.
Submitting this Form This form will not be sent to the office unless you click on the SUBMIT button at the bottom of this page.
For security purposes, please enter the text that appears in the box below.
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Online Giving

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