Parish Registration Form

Today's Date Please enter valid data.

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

Home Phone Number Please enter valid data.

Home Address Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Marital Status REQUIRED Please fill out this field.

If married in a Catholic Church, please enter the name and address of the Catholic Church.

Date of marriage in the Catholic Church Please enter valid data.

***IF YOU ARE NOT MARRIED, ONLY FILL OUT SPACES THAT APPLY TO YOU.

Male's First & Middle Name Please enter valid data.

Birth Date (mmm/dd/yyyy) Please enter valid data.

Religion REQUIRED Catholic Non-Catholic Please fill out this field.

Sacraments Received REQUIRED Baptism First Pennance First Holy Communion Confirmation Matrimony None Please fill out this field.

E-mail address (male) Please enter valid data.

Cell Phone Number (male) Please enter a phone number.

Female's First & Middle Name Please enter valid data.

Maiden Name Please enter valid data.

Birth Date (mmm/dd/yyyy) Please enter valid data.

Religion REQUIRED Catholic Non-Catholic Please fill out this field.

Sacraments Received REQUIRED Baptism First Pennance First Holy Communion Confirmation Matrimony None Please fill out this field.

Phone Number REQUIRED Home Cell Please fill out this field.

Cell Phone Number (female) Please enter a phone number.

E-mail address (female) Please enter valid data.

Mailing Address (if different from above) Please enter valid data.

Primary Mass attending REQUIRED 5:00 PM Saturday 8:00 AM Sunday 10:30 AM Sunday Please fill out this field.

Tithing Option REQUIRED Request Envelopes Online Giving Please fill out this field.

Dependent Child #1

Dependent Child #2

Dependent Child #3

Dependent Child #4

Dependent Child #5

Dependent Child #6

Dependent Child #7

Dependent Child #8

Have you received VIRTUS Training? (The VIRTUS Protecting God's Children training is required for all volunteers and employees in the Diocese of Savannah.) REQUIRED Yes No Please fill out this field.

Is there anything else you would like for us to know about your family? (Special Needs, Shut-In, etc.) Please enter valid data.

Other: Please enter valid data.

Saint Anne
Catholic Church

Richmond Hill, Georgia

Parish Registration Form