New Parishioner Registration

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Welcome...

to St. Mary of the Assumption Catholic Church. We look forward to having you join our parish.

To register as a new member or update your information, please fill out the form below. Submitting the form, when complete, will send your information to us.
New Parishioner Registration Form
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- Registration Option REQUIRED Please fill out this field.
- Step 1:
  
  Head of Household
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Marital Status REQUIRED Please fill out this field.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Step 2:
  
  Spouse
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
- Step 3:
  
  Family Street Address
  
  Line 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Line 2 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.
- Step 4:
  
  Family Mailing Address
  
  Line 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Line 2 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.
- Step 5:
  
  Additional Family Members
- Number of Members REQUIRED Please fill out this field.
  
  Member 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 5
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 6
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 7
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
  
  Member 8
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter valid data.
  
  Gender Female Male
  
  Marital Status
  
  Phone Number Please enter a phone number.
  
  Email Please enter an email address.
- Email Please enter an email address.
Submit