Name * First Name Last Name DOB * MM DD YYYY Email * Subject * Message * Gender * Female Male Phone * (###) ### #### Occupation * Status * Single Married Widowed Divorce Other Baptized? * Yes No First Communion? * Yes No Confirmation? * Yes No Address Address 1 Address 2 City State/Province Zip/Postal Code Country If Married, please fill out the portion below. If not, please skip this part Anniversary Date: MM DD YYYY Will Spouse be Joining? Yes No Spouse Name First Name Last Name Spouse DOB MM DD YYYY Spouse Gender Yes No Phone (###) ### #### Email Occupation Baptized? Yes No First Communion? Yes No Confirmation? Yes No Other people living at the home: Areas you may desire to serve: Are there any special needs/health issues we should be aware of? Dietary restrictions (i.e. low-gluten host)? Other information you want to share about yourself (hobbies, interests, etc.)? Would you like to receive envelopes for the year? Yes No Signature * Today's Date * MM DD YYYY Thank you for completing the New Member Registration Form at Our Lady of Grace Catholic Church. Welcome to our church community! Member Registration Form Member Registration Form Member Registration Form
