Parish Registration Form Revised November 2020

Please fill out the form as completely as possible and then click submit.  If you have more then 5 family members please indicate that there are additional members in the additional comments at the end of the form.  

If you have any questions contact the parish office at 847-888-2828 press 0 to connect with the parish secretary. 

Family General Information
Family Name
  •  
Address
  •  
Home Phone --
  •  
E-mail
  •  
Head of Household
Title:
  •  
Name
  •  
 Please include last name if different from family name
Date of Birth //
  •  
E-mail
  •  
Cell Phone Number --
  •  
Marital Status
  •  
Maiden Name if applicable
  •  
Wedding Date (if applicable) //
  •  
Wedding Parish Name, City, State
  •  
Gender
  •  
Primary Language
  •  
Religion
  •  
Profession
  •  
Employer/School
  •  
Business Phone -- ext
  •  
Last Grade or Degree Completed
  •  
Baptized
  •  
Baptism Parish Name, City and State
  •  
First Reconciliation
  •  
First Reconciiation Parish Name, City, State
  •  
First Communion
  •  
First Communion Parish Name, City, State
  •  
Confirmed
  •  
Confimation Parish Name, City, State
  •  
Family Member 2
Relationship to Head of Household
  •  
Name
  •  
 Please include last name if different from family name
Title
  •  
Cell Phone Number --
  •  
E-mail
  •  
Marital Status
  •  
Maiden Name if applicable
  •  
Gender
  •  
Date of Birth //
  •  
Primary Language
  •  
Religion
  •  
Profession
  •  
Employer/School
  •  
Business Phone -- ext
  •  
Last Grade or Degree Completed
  •  
Baptized
  •  
Baptism Parish Name, City and State
  •  
First Reconciliation
  •  
First Reconciiation Parish Name, City, State
  •  
First Communion
  •  
First Communion Parish, City, State
  •  
Confirmed
  •  
Confimation Parish Name, City, State
  •  
Family Member 3
Relationship to Head of Household
  •  
Name
  •  
 Please include last name if different from head of household
Title
  •  
Cell Phone Number --
  •  
E-mail
  •  
Marital Status
  •  
Maiden Name if applicable
  •  
Gender
  •  
Date of Birth //
  •  
Primary Language
  •  
Religion
  •  
Profession
  •  
Employer/School
  •  
Business Phone -- ext
  •  
Last Grade or Degree Completed
  •  
Baptized
  •  
Baptism Parish Name, City and State
  •  
First Reconciliation
  •  
First Reconciiation Parish Name, City, State
  •  
First Communion
  •  
First Communion Parish, City, State
  •  
Confirmed
  •  
Confimation Parish Name, City, State
  •  
Family Member 4
Relationship to Head of Household
  •  
Name
  •  
 Please inclued last name if different from head of household
Title
  •  
Cell Phone Number --
  •  
E-mail
  •  
Marital Status
  •  
Maiden Name if applicable
  •  
Gender
  •  
Date of Birth //
  •  
Primary Language
  •  
Religion
  •  
Profession
  •  
Employer/School
  •  
Business Phone -- ext
  •  
Last Grade or Degree Completed
  •  
Baptized
  •  
Baptism Parish Name, City and State
  •  
First Reconciliation
  •  
First Communion
  •  
First Communion Parish, City, State
  •  
Confirmed
  •  
Confimation Parish Name, City, State
  •  
Family Member 5
Relationship to Head of Household
  •  
Name
  •  
 Please inclued last name if different from head of household
Title
  •  
Cell Phone Number --
  •  
E-mail
  •  
Marital Status
  •  
Maiden Name if applicable
  •  
Gender
  •  
Date of Birth //
  •  
Primary Language
  •  
Religion
  •  
Profession
  •  
Employer/School
  •  
Last Grade or Degree Completed
  •  
Baptized
  •  
Baptism Parish Name, City and State
  •  
First Reconciliation
  •  
First Reconciiation Parish Name, City, State
  •  
First Communion
  •  
First Communion Parish, City, State
  •  
Confirmed
  •  
Confimation Parish Name, City, State
  •  
Additional Information
Flocknotes
  •  
 Please indicate if you would like to be part of our Flocknote system. Flocknotes is a text/email system that our parish uses to commuicate important information and upcoming events.
Additional Comments
  •  
Spam Capture
  •  
 
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