New Family Registration

Please complete the following. Fill out the "Family" section; the Male Head of Household or Female Head of Household section, or both, as appropriate; the "Details on the Couple" section; and section(s) for any children. If you would like to register in person, come to the parish office. You may also register by telephone at 233-4780.

Please be sure to click "Submit" when you reach the end of the form.

Family

Family 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 #1 Maximum 20 characters Please enter a phone number.
Phone Number #2 Maximum 20 characters Please enter a phone number.
Email Please enter an email address.

Male Head of Household

None
Name Please enter valid data.
Date of Birth Please enter a date.
Religion Please enter valid data.
Joined Church Please enter valid data.
Mass Attendance
Baptism Yes No
Place of Baptism Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
Place of Employment Please enter valid data.
Work Phone Maximum 20 characters Please enter a phone number.
May We Call at Work? Yes No
Occupation Please enter valid data.
Education

Female Head of Household

None
Name Please enter valid data.
Date of Birth Please enter a date.
Religion Please enter valid data.
Joined Church Please enter valid data.
Mass Attendance
Baptism Yes No
Place of Baptism Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
Place of Employment Please enter valid data.
Work Phone Maximum 20 characters Please enter a phone number.
May We Call at Work? Yes No
Occupation Please enter valid data.
Education

Details on the Couple

Current Marital Status Single: Never Married Married Living Together Widowed Divorced Separated
Place and Date of Marriage Please enter valid data.
Special Ministry
Next of Kin
Comments

If there are no children, skip to the end. Please be sure to click "Submit".

Child No. 1

Name Please enter valid data.
Sex Male Female
Date of Birth Please enter a date.
Religion Please enter valid data.
Age Please enter an integer (number).
Baptism Yes No
Place of Baptism Please enter valid data.
Eucharist Yes No
Place of Eucharist Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
School Please enter valid data.
Grade Please enter valid data.
Special Accommodations or Needs
If there are no more children, skip to the end. Please be sure to click "Submit".

Child No. 2

Name Please enter valid data.
Sex Male Female
Date of Birth Please enter a date.
Religion Please enter valid data.
Age Please enter an integer (number).
Baptism Yes No
Place of Baptism Please enter valid data.
Eucharist Yes No
Place of Eucharist Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
School Please enter valid data.
Grade Please enter valid data.
Special Accommodations or Needs
If there are no more children, skip to the end. Please be sure to click "Submit".

Child No. 3

Name Please enter valid data.
Sex Male Female
Date of Birth Please enter a date.
Religion Please enter valid data.
Age Please enter an integer (number).
Baptism Yes No
Place of Baptism Please enter valid data.
Eucharist Yes No
Place of Eucharist Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
School Please enter valid data.
Grade Please enter valid data.
Special Accommodations or Needs
If there are no more children, skip to the end. Please be sure to click "Submit".

Child No. 4

Name Please enter valid data.
Sex Male Female
Date of Birth Please enter a date.
Religion Please enter valid data.
Age Please enter an integer (number).
Baptism Yes No
Place of Baptism Please enter valid data.
Eucharist Yes No
Place of Eucharist Please enter valid data.
Confirmation Yes No
Place of Confirmation Please enter valid data.
School Please enter valid data.
Grade Please enter valid data.
Special Accommodations or Needs
If you have more than four children, bless you! Please submit a second registration form.
Please be sure to click "Submit".

St. Francis de Sales Church

THE CATHOLIC COMMUNITY FOr
NORTH MOORHEAD, MINN., U.S.A.

New Family Registration