New Parishioner Registration

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- Welcome and thank you for registering with Assumption Parish. Please fill in the information below and click on Submit to email this information to the Parish Office. You will receive a confirmation email upon submitting.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email Please enter an email address.
- Would You Like Offertory Envelopes? REQUIRED Please fill out this field.
- Adult Members REQUIRED Please fill out this field.
  
  Adult 1
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name (if different from family name)
  if different from family name
  Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Occupation Please enter valid data.
  
  Birthdate Please enter a date.
  
  Adult 2
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name (if different from family name)
  if different from family name
  Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Occupation Please enter valid data.
  
  Birthdate Please enter a date.
  
  Adult 3
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name (if different from family name)
  if different from family name
  Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Occupation Please enter valid data.
  
  Birthdate Please enter a date.
  
  Adult 4
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name (if different from family name)
  if different from family name
  Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Occupation Please enter valid data.
  
  Birthdate Please enter a date.
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  Relationship REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Last Name (if different from family name) Please enter valid data.
  
  Birthdate Please enter valid data.
  
  Child 2
  
  Relationship REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Last Name (if different from family name) Please enter valid data.
  
  Birthdate Please enter valid data.
  
  Child 3
  
  Relationship REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Last Name (if different from family name) Please enter valid data.
  
  Birthdate Please enter valid data.
  
  Child 4
  
  Relationship REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Last Name (if different from family name) Please enter valid data.
  
  Birthdate Please enter valid data.
- Please indicate any special needs or interests.
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New Parishioner Registration

Welcome and thank you for registering with Assumption Parish. Please fill in the information below and click on Submit to email this information to the Parish Office. You will receive a confirmation email upon submitting.