Join St Patrick - St. Patrick Catholic Church

Name of Registrant *

First

Last

Preferred Title *

Spouse Registrant (if applicable)

First

Last

Preferred Title

Salutation you would like the Church to use:

Example: Mr. and Mrs. Smith or Smith Family

Former Catholic Parish

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Neighborhood

Primary Email *

Additional Email

Primary Phone *

Alternate Phone

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Marital Status

Marriage Date//

Is current marriage recognized as valid by the Catholic Church?

Yes
No
Unsure

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Birthday of Primary Registrant *//

Religion *

Catholic Sacraments Received

Baptism
Eucharist
Confirmation
None

Church (Name and City, State) Where Above Sacraments Received

Occupation

Employer

Work Phone

Cell Phone

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Birthday of Spouse//

Spouse Religion

Catholic Sacraments Received by Spouse

Baptism
Eucharist
Confirmation
None

Church (Name and City, State) Where Above Sacraments Received

Spouse Occupation

Spouse Employer

Work Phone

Cell Phone

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Child #1 Name

First

Last

Child #1 Birthday//

Gender

Male
Female

Religion

Catholic Sacraments Received by Child #1

Baptism
Eucharist
Confirmation
None

Church (Name and City, State) Where Above Sacraments Received

Marital Status

Married
Single, No Longer Living at Home
Single, Working/College, Living at Home
Single, School Age

School Attending

Child #2 Name

First

Last

Child #2 Birthday//

Gender

Male
Female

Religion

Catholic Sacraments Received by Child #2

Baptism
Eucharist
Confirmation
None

Church (Name and City, State) Where Above Sacraments Received

Marital Status

Married
Single, No Longer Living at Home
Single, Working/College, Living at Home
Single, School Age

School Attending

Child #3 Name

First

Last

Child #3 Birthday//

Gender

Male
Female

Religion

Catholic Sacraments Received by Child #3

Baptism
Eucharist
Confirmation
None

Church (Name and City, State) Where Above Sacraments Received

Marital Status

Married
Single, No Longer Living at Home
Single, Working/College, Living at Home
Single, School Age

School Attending

Reason for Joining St Patrick Gretna *

Relocated to Gretna
Moving from nearby parish
Rejoining the Catholic Church
Other

Additional Comments

Additional children or anything else you would like to share with St Patrick Church.

Join the St. Patrick Community

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