Information

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Join St. Charles Borromeo Catholic Parish

IMPORTANT: To register at St. Charles, please complete the form below AND submit to the Parish Office a copy of your baptismal certificate. All fields below that are applicable for you are required, including sacramental dates for all family members. This information is important.

First & Last Name*	Mr. Ms. Mrs. Dr.
Spouse's First & Maiden Name
Marital Status *	Married by Priest Married by Minister/Justice Never Married Divorced Widowed Separated
Street Address *
City & Zip Code *
E-mail Address*
Phone Number*	Listed Unlisted
Number of Children	At Home: Away from Home:
Last Church Attended*	Name: City & State:
Comments?

 

	Head	Spouse	Child 1	Child 2
Last (Maiden) Name *
First Name & Initial*
Sex*	Male Female	Male Female	Male Female	Male Female
Birth date* mm/dd/yyyy
Religion*
Baptized mm/dd/yyyy
Reconciliation* mm/dd/yyyy
Communion* mm/dd/yyyy
Confirmation* mm/dd/yyyy
Married mm/dd/yyyy
RCIA
Languages Spoken
Living at Home? *	Yes No	Yes No	Yes No	Yes No
Shut in?	Yes No	Yes No	Yes No	Yes No
Handicap?	Yes No	Yes No	Yes No	Yes No
Occupation*

 

	Child 3	Child 4	Child 5	Child 6
Last (Maiden) Name *
First Name & Initial*
Sex*	Male Female	Male Female	Male Female	Male Female
Birth date* mm/dd/yyyy
Religion*
Baptized* mm/dd/yyyy
Reconciliation* mm/dd/yyyy
Communion* mm/dd/yyyy
Confirmation* mm/dd/yyyy
Married mm/dd/yyyy
RCIA
Languages Spoken
Living at Home? *	Yes No	Yes No	Yes No	Yes No
Shut in?	Yes No	Yes No	Yes No	Yes No
Handicap?	Yes No	Yes No	Yes No	Yes No
Occupation

The information above is correct and complete.

I realize I need to supply the Parish Office with a copy of my baptismal certificate in order to become a member at St. Charles. (Non-Catholics: Please call the office about RCIA!)