St. Francis of Assisi welcomes you to join our church community. If you would like to register in our parish, complete the form below and click on SUBMIT. Please allow 1 to 2 business days for processing of your registration. You will receive a follow-up e-mail or phone call for more information about our church. Thank you and we look forward to seeing you at St Franics of Assisi.

GENERAL INFORMATION:
Family Last Name		A value is required.
Status: (Please choose one)		Married Single Widow(er) Separated Divorced
Street Address:
City:
State:		Choose State Alabama Alaska Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Misouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Mailing Address: (If different from above)
City:
State:		Choose State Alabama Alaska Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Misouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Home Phone:		A value is required.Invalid format. Use format 123-456-7890				check if you do not wish your number listed or available
E-mail:		A value is required.Invalid email address.
Former Parish:
	Parish City:
	Parish State:	Choose State Alabama Alaska Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Misouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
FAMILY INFORMATION: (Please complete for each family member living in household)

Click on this tab to enter Member #1 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:	Invalid format.
	Work:	Invalid format.
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #2 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #3 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #4 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #5 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #6 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #7 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #8 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #9 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Click on this tab to enter Member #10 Info

Relationship:		Self Husband Wife Son Daughter Parent Grandparent Aunt Uncle Cousin Other
Title:		Mr. Mrs. Ms. Dr.
First Name:
Preferred Salutation/Nickname:
Last Name: (if different from family name)
Suffix:		None Jr. Sr. II III IV V Other
Additional Phone:
	Mobile:
	Work:
Email: (if different from above)
Occupation:
Birthdate:
Religion: (if other than Catholic)
Language(s) Spoken:
Sacraments Received:
	Baptism	1st Communion	1st Reconciliation	Confirmation

Special Instructions:


Check if you prefer email instead of mail correspondence if possible