St. Mildred Catholic Church Registraton Form.

1. Marital Status, Sex and E-Mail Address

Are you:  
Sex  

2. Please fill in your complete address

3. Mailing address if different from above.

4. Telephone to include area code.

5. Envelopes

Do you want envelopes?  
 YesNo
Church

6. Information for each person that you are registering. If you are registering as a SINGLE , DIVORCED or WIDOWED person please use the OTHER line for you information.

Please fill out Full Name, Date of Birth, Religion of Husband/Wife . Please put a x in unused blocks.  
 Name (Last, First)Date of Birth MM/DD/YYReligion
Husband
Wife
Please fill out Full Name, Date of Birth, Religion of Children that are living with you. Children over 21 should register on their own. 
 Name (Last, First)Date of Birth MM/DD/YYReligion
Child 1
Child 2
Child 3
Child 4
Please fill out Full Name, Date of Birth, Religion if you are Single, Divorced or Windowed. 
 Name (Last, First)Date of Birth MM/DD/YYReligion
Other
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