Parish Registration Form

REGISTRATION FOR OUR LADY OF PEACE PARISH

 

Please fill in the information below to the best of your knowledge, place in the collection basket, drop off or mail to the rectory at 10950 Main St., Clarence, NY  14031 and you will be registered. Envelopes are mailed every two months. We will send temporaries out to you until these are available. Children over 18 years of age need to register separately.

 

Family Name:____________________________________________________  

Street Address___________________________________________________

City/Town: __________________________________________    Zip _______     

Phone _____________ (Home)   _______________ (Cell)

Email: ____________________________________

 

Head of Household’s First Name: __________________     Middle Name_______________ 

Date of Birth: _______________       Occupation:  ___________________________        

Religion: __________________         Church Where Baptized:  _________________

Did you make First Eucharist?  ___ yes   ___ no 

Confirmation? __ yes __ no

 

Spouse’s First Name: ________________________ Middle Name________________

Maiden Name______________________

Date of Birth _______________      Occupation ____________________________

Religion: ___________________       Church Where Baptized __________________

Did you make First Eucharist?  ___ yes   ___ no 

Confirmation?  __yes __ no

 

Marital Status: _____ Single _____ Married _____ Separated

                            _____ Divorced      _____ Widowed

 

If married, is this a Church Marriage?  ___ yes  ` ___no     Church_____________________________

City, State___________________________________________ Date_________

 

Child #1: First Name______________________     Middle Name______________________

Date of Birth ______________   Current Grade __________

Church Where Baptized __________________

Did child make First Eucharist?  ___yes   ___ no 

Confirmation?  __yes __ no

 

Child #2: First Name ______________________     Middle Name______________________

Date of Birth ______________   Current Grade __________

Church Where Baptized __________________

Did child make First Eucharist?  ___ yes   ___ no 

Confirmation?  __yes   __ no

 

Child #3: First Name_______________________     Middle Name______________________

Date of Birth ______________   Current Grade __________

Church Where Baptized __________________

Did child make First Eucharist?  ___yes   ___ no 

Confirmation?  __yes __ no

 

If you need extra space, please add additional sheets

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For church use only: Welcome letter sent _______________ (date) ________ (initial)