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New Parishioner Registration Form

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The maximum number of form submissions has been reached. This form is currently not available.
- Welcome to St. Catherine's! We're so glad you've decided to join our parish! Please complete the first part of this registration form for yourself. If you would like to register additional family members living in your household, please indicate the total number of additional family members living in your household in the field where indicated and then complete the information requested for each additional family member.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Maiden Name (if applicable) Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Your Title REQUIRED Please fill out this field. Please enter valid data.
- Type: REQUIRED Adult 1 Adult 2 Please fill out this field.
- Your Gender REQUIRED Male Female Please fill out this field.
- Your Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Your Employer (if unemployed, please type "None") REQUIRED Please fill out this field. Please enter valid data.
- Your Occupation / Business (if unemployed, please type "None") REQUIRED Please fill out this field. Please enter valid data.
- Your 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.
- Your Primary Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Phone Number Type: REQUIRED Home Mobile Work Please fill out this field.
- Unlisted? Yes No
- Alternate Phone Number (please indicate type below) Please enter a phone number.
- Phone Number Type: Home Mobile Work
- Your Primary Email Address REQUIRED Please fill out this field. Please enter an email address.
- Alternate Email Address (if applicable) Please enter an email address.
- Your Baptismal Information
  
  Please complete the following section if you have been baptized (whether Catholic or other faith).
  
  Church of Baptism Please enter valid data.
  
  City / State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  First Communion Date Please enter a date.
  
  Reconciliation Date Please enter a date.
  
  Confirmation Date Please enter a date.
- Your Current Marital Status REQUIRED Married (please complete Marriage section below) Single Widowed (please complete Marriage section below) Divorced (please complete Marriage section below) Separated (please complete Marriage section below) Please fill out this field.
- Your Marriage Information (if applicable)
  
  Spouse Name (First, Middle, Maiden, Last) Please enter valid data.
  
  Church of Marriage Please enter valid data.
  
  City / State of Marriage Please enter valid data.
  
  Date of Marriage Please enter a date.
- Your Former Parish (if applicable) Please enter valid data.
- How can we serve your family? Religious Education / Children's Faith Formation Classes House Blessing RCIA / Interested in Becoming Catholic Baptism Marriage Preparation Other
- I would prefer to contribute: with envelopes using Online Giving (stcatherinesiena.org/give) using online banking through automatic withdrawl (ACH)
- Why did you choose St. Catherine's?
- Are there additional family members living in your household? If so, please indicate the total number of ADDITIONAL family members (not including yourself) you would like to register in the field below.
- Number of Additional Family Members Living in Your Household REQUIRED
  Please indicate the total number of ADDITIONAL family members living in your household (NOT including yourself)
  Please fill out this field.
  
  Additional Family Member 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
  
  Additional Family Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name (if applicable) Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Type REQUIRED Adult 1 Adult 2 Child (please indicate grade below) Other (please indicate in field below) Please fill out this field.
  
  Other Family Member Type: Please enter valid data.
  
  Current Grade (children only)
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number (if different from above) Please enter a phone number.
  
  Phone Number Type: Home Mobile Work
  
  If this family member has received any sacraments, please complete the information below.
  
  Church of Baptism Please enter valid data.
  
  City/State of Baptism Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Date of First Reconciliation Please enter a date.
  
  Date of First Eucharist Please enter a date.
  
  Date of Confirmation Please enter a date.
Submit

St. Catherine of Siena Parish

Portage, MI

New Parishioner Registration Form