Today's Date                                      
                           
Family Information

Family Last Name                                                               (For our record keeping)

Residence Address

CityState  Zip Code

Mailing Address

Mailing Address

City State Zip Code

Home Phone    Work Phone   Cell Phone
            
Marital Status

Head of Household Information

First & Last Name                                                     Gender

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed

Occupation

Spouse or Significant Other Information

First & Last Name

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed

Occupation

Children and Other Adults Living at this Address (add adult names only if they will not register separately)

1.  First & Last Name                                                                                               Gender

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed

2.  First & Last Name                                   Gender

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed


3.  First & Last Name                                                                                               Gender

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed

4.  First & Last Name                                   Gender

ReligionCountry of BirthDate of Birth

BaptizedFirst CommunionConfirmed

Additional Information

For donation tracking, do you want to receive offertory envelopes?

Spouse's Maiden Name (Important, if applicable)

Are you going to submit another form to add more children and/or adults?                 If yes, then:

1.  Submit this form first.
2.  Clear form and begin with a new blank form.
3.  Fill in "Family Last Name" field with the same name as entered on page 1.
4.  In address box, type "Page 2" (or "Page 3" etc.).
5.  Go directly to "Children and Other Adults Living at this Address" area and continue to add names.
6.  Submit form.

For our files, what is your email address?




Saint Rita Catholic Church
Wellington, Florida

Church Registration Form For New Members
Please DO NOT use this form to notify us of updates to your original registration information; call the church office.
Enter dates:  mm-dd-yyyy.  Enter phone numbers:  999-999-9999.  Thank you.
If same as Residence Address, skip to Home Phone
(mm-dd-yyyy)