Parishioner Registration Form (for New parishioners)

Today's Date REQUIRED Please fill out this field. Please enter a date.

Head of Household Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Street 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.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Catholic? REQUIRED Please fill out this field.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Current Marital Status Single Married in the Church Married Other Widowed Divorced Separated Never Married

Anniversary Date Please enter a date.

If you were not married in the Church, would you like to discuss receiving the Sacrament of Marriage with a priest or Pastoral Staff member? REQUIRED Yes No N/A Please fill out this field.

Spouse's Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Catholic? REQUIRED Please fill out this field.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Children Living at Home

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Currently Attending REQUIRED Please fill out this field. Please enter valid data.

Grade

Type N/A, if Not Applicable

Please enter valid data.

What Sacraments has this child received? Check all that apply. REQUIRED Baptism First Confession First Holy Communion Confirmation Please fill out this field.

Are you interested in receiving more information about Children's or Teen's Faith Formation? REQUIRED Yes No Please fill out this field.

Children Living at Home

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Currently Attending REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field. Please enter valid data.

What Sacraments has this child received? Check all that apply. REQUIRED Baptism First Confession First Holy Communion Confirmation Please fill out this field.

Are you interested in receiving more information about Children's or Teen's Faith Formation? REQUIRED Yes No Please fill out this field.

Children Living at Home

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Currently Attending REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field. Please enter valid data.

What Sacraments has this child received? Check all that apply. REQUIRED Baptism First Confession First Holy Communion Confirmation Please fill out this field.

Are you interested in receiving more information about Children's or Teen's Faith Formation? REQUIRED Yes No Please fill out this field.

Children Living at Home

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Currently Attending REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field. Please enter valid data.

What Sacraments has this child received? Check all that apply. REQUIRED Baptism First Confession First Holy Communion Confirmation Please fill out this field.

Are you interested in receiving more information about Children's or Teen's Faith Formation? REQUIRED Yes No Please fill out this field.

Special Issues or Questions

How can the parish assist you and your family with sacramental needs? Please check all that apply. REQUIRED Anointing of the Sick Baptism - Infant Confirmation - High School Youth Confirmation - Adults First Reconciliation & First Holy Communion Preparation Marriage Becoming Catholic (RCIA) Please fill out this field.

If someone listed above is not presently Catholic, would you like to discuss becoming Catholic with a parish staff member? REQUIRED Yes No N/A Please fill out this field.

There are a number of wonderful ministries within the church. We can help you connect with any specific parish ministry. Please comment below. REQUIRED Please fill out this field.

Do you have questions for us? Please comment below. We look forward to serving you. REQUIRED Please fill out this field.

Sacred Heart Catholic Church

529 I Street
Patterson, CA 95363

Parishioner Registration Form (for New parishioners)

Welcome to Sacred Heart Parish

General Registration Information

Head of Household Information

Spouse's Information

Children Living at Home

Children Living at Home

Children Living at Home

Children Living at Home

Special Issues or Questions