Today's Date                                                   Required information in red
                           
Family Information

Family Last Name                                                              

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

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

2.  Spouse's Maiden Name (Important, if applicable)

3.  In order for us to help serve you and reduce the expenses incurred sending letters and postcards to our parish family, your email address is requested.  Please call us when this address changes or is eliminated.  Thank you.

My preferred correspondence method is

Email address:            enter "none" if you do not have or do not want to use an email address.

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

1.  Submit this page first.
2.  On the acknowledgement page, click "back."
3.  In the Residence Address space on the new blank form, type "PAGE 2" (or "PAGE 3," etc).
4.  Fill in all the required fields again.
5.  In the "Children and Other Adults Living at this Address" section, continue to add names and information.
6.  Submit form.


Before you submit this form, we would like to know if there are any church ministies you would be interested in.  If so, please
indicate that here:



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 as:  mm-dd-yyyy.  Enter phone numbers as:  999-999-9999.  Thank you.
If same as Residence Address, skip to Home Phone
(mm-dd-yyyy)
Email
Mail