ST. PIUS X PARISH REGISTRATION FORM

Family (Last) Name:

Mailing Address:

City: State: Zip:

Street Address (if different from Mailing Address):

Home Phone:

Family’s Primary Email Address:

Male Cell/ Work Phone:

Female Cell/ Work Phone:

Parish of Previous Registration:

Church Name:

Address:

City: State: Zip:

 

Members of the Household

Family Member 1

Salutation: Name First & Middle

Date of Birth: (please enter mm/dd/yyyy)   M   F

Marital Status:

Occupation: Employer:

First Language: Ethnicity:

Religion if not Catholic:

Check Sacraments received:
Baptism   Reconciliation    Communion    Confirmation    Catholic Marriage

 

Spouse:

Salutation: Name First & Middle

Date of Birth: (please enter mm/dd/yyyy)

Occupation: Employer:

First Language: Ethnicity:

Religion if not Catholic:

Check Sacraments received:
Baptism   Reconciliation    Communion    Confirmation    Catholic Marriage

 

Child 1:

School: Grade:

Check Sacraments received:
Baptism   Reconciliation    Communion    Confirmation

 

Child 2:

School: Grade:

Check Sacraments received:
Baptism   Reconciliation    Communion    Confirmation

 

Additional Family Members:

 

May we publish photos of your family members participating in our parish life activities? Yes   No

Do you have any special needs or situations that you wish to call to our attention? Check here and we will contact you personally.

 

Would you like to volunteer in any way at our parish? (indicate name and volunteer commitment)

 

Offertory Donations at Mass
For the Financial Security of Church of St. Pius X and its programs, you will receive offertory envelopes in the mail
or you may sign-up for Online Giving for automatic giving by bank or credit card. The expression of your offertory
commitment helps us plan our budget.

$ per week

 

Renovation Fund
To build our church home – donations to the fund will be tax exempt for the church. Please write a separate checks
for your Building Fund contribution as we must account for the tax-exempt contribution separately. The expression
of your Renovation Fund Commitment move us closer to our goals to completely renovate our Church.

$ per   week     month      semi-annually      annually

Beginning (mo./day/year) Ending (mo./day/year)

$ as a one-time gift.

 

May God Bless you in your commitment of Stewardship!