Welcome to the Immaculate Heart of Mary Catholic Church on-line registration. All parish registration information is confidential and will only be used for the purpose of registering you and/or your family with the Immaculate Heart of Mary Catholic Church. We do not and will not share your information with any other individuals or businesses. This is our pledge to you!
About You
Your Privacy
Is Our Priority
This information
is confidential and will only be used for the purpose
of registering you and/or
your family with the Immaculate Heart of Mary Catholic Church.
We do not and will not share your information with any other individuals
or businesses.
This is our pledge to you!
Your Full Name
Sacraments Received
Your Home Phone
Your Work Phone
Your Email Address
Your Cell Phone
Your Mailing Address
Your Street Address
Your Date of Birth (mm/dd/yyyy)
Are you a convert to Catholicism?
When did you begin attending this parish?
Your Religion
Your Spouse's Full Name
Sacraments Received
Your Spouse's Cell Phone
Your Spouse's Work Phone
Your Spouse's Email Address
Your Spouse's Occupation
Your Occupation
Your Spouse's Religion
If your spouse is Catholic, is he/she a convert?
About Your Spouse
About Children / Young Adults Living with You
1. Your Child's Full Name
Sacraments Received
Child's Relationship to you:
Child's Date of Birth (mm/dd/yyyy)
Your Child's Email Address
2. Your Child's Full Name
Sacraments Received
Child's Relationship to you:
Child's Date of Birth (mm/dd/yyyy)
Your Child's Email Address
About Other Adults Living with You
1. Other Adult's Full Name
Other Adult's Date of Birth (mm/dd/yyyy)
Other Adult's Relationship to You
Other Adult's Religion
Other Adult's Sacraments Received
2. Other Adult's Full Name
Other Adult's Date of Birth (mm/dd/yyyy)
Other Adult's Relationship to You
Other Adult's Religion
Other Adult's Last Name
Does This Adult Have Disability Needs?
Describe Disability
Your Talent and Gifts
Volunteer ministers are needed to help serve the Lord at the Immaculate Heart of Mary Catholic Church. Please check which areas you are interested in serving. Training will be provided. All it takes is a willingness to serve.
Do you have other talents and gifts that you would like to offer for the maintenance and upkeep of our faith community?
Other Skills:
Additional comments:
Your Ethnic Background
Your Spouse's Ethnic Background
Other Adult's Ethnic Background
Other Adult's Ethnic Background
Describe your disability needs:
Describe your spouse's disability needs:
Describe your child's disability needs:
Describe your child's disability needs:
3. Your Child's Full Name
Sacraments Received
Child's Relationship to you:
Child's Date of Birth (mm/dd/yyyy)
Your Child's Email Address
Describe your child's disability needs:
4. Your Child's Full Name
Sacraments Received
Child's Relationship to you:
Child's Date of Birth (mm/dd/yyyy)
Your Child's Email Address
Describe your child's disability needs:
Describe other adult's disability needs:
Additional children / young adults living with you:
