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  • Family Last Name Please enter valid data.
  • Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Street Address REQUIRED Please fill out this field. Please enter valid data.
  • Mailing Address (Street/PO Box) Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Primary Email REQUIRED Please fill out this field. Please enter an email address.
  • Alternate Address Please enter valid data.
  • Alternate Mailing Address Please enter valid data.
  • Alternate Phone Number Please enter a phone number.
  • Family Type REQUIRED Family-With Children Under 18 Married Widowed Single Divorced Separated Please fill out this field.
  • Family Member #1
    • First Name REQUIRED Please fill out this field. Please enter valid data.

      Last Name REQUIRED Please fill out this field. Please enter valid data.
    • Date of Birth REQUIRED Please fill out this field. Please enter valid data.
    • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
    • Email REQUIRED Please fill out this field. Please enter an email address.
    • Baptized REQUIRED Yes No Please fill out this field.
    • First Communion REQUIRED Yes No Please fill out this field.
    • Confirmed REQUIRED Yes No Please fill out this field.
    • Married REQUIRED Yes No Please fill out this field.
    • Sacramental Marriage REQUIRED Yes No Please fill out this field.
    • Religion if not Catholic: Please enter valid data.
    • Field of Study REQUIRED Please fill out this field. Please enter valid data.
    • Highest Grade Completed REQUIRED Please fill out this field. Please enter valid data.
    • Foreign Language Spoken REQUIRED Please fill out this field. Please enter valid data.
    • Are you retired? REQUIRED Yes No Please fill out this field.
    • Current Employer Please enter valid data.
    • Position Please enter valid data.
    • Work Phone Number Please enter valid data.
  • Family Member #2
    • First and Last Name Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Baptized Yes No
    • First Communion Yes No
    • Confirmed Yes No
    • Married Yes No
    • Sacramental Marriage Yes No
    • Religion if not Catholic: Please enter valid data.
    • Field of Study Please enter valid data.
    • Highest Grade Completed Please enter valid data.
    • Foreign Language Spoken Please enter valid data.
    • Are you retired? Yes No
    • Current Employer Please enter valid data.
    • Position Please enter valid data.
    • Work Phone Number Please enter valid data.
  • Members Living in Household if NOT Registered Separately
  • Family Member #3
    • First and Last Name Please enter valid data.
    • Male or Female Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Sacramental

      Check all that apply.

      Baptized First Communion Confirmed Married Sacramental Marriage Attends Religious Formation
    • Present School or Employer Please enter valid data.
    • Currently Attends St. MIchael Academy Yes No
  • Family Member #4
    • First and Last Name Please enter valid data.
    • Male or Female Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Sacramental

      Check all that apply.

      Baptized First Communion Confirmed Married Sacramental Marriage Attends Religious Formation
    • Present School or Employer Please enter valid data.
    • Currently Attends St. MIchael Academy Yes No
  • Family Member #5
    • First and Last Name Please enter valid data.
    • Male or Female Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Sacramental

      Check all that apply.

      Baptized First Communion Confirmed Married Sacramental Marriage Attends Religious Formation
    • Present School or Employer Please enter valid data.
    • Currently Attends St. MIchael Academy Yes No
  • Family Member #6
    • First and Last Name Please enter valid data.
    • Male or Female Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Sacramental

      Check all that apply.

      Baptized First Communion Confirmed Married Sacramental Marriage Attends Religious Formation
    • Present School or Employer Please enter valid data.
    • Currently Attends St. MIchael Academy Yes No
  • Family Member #7
    • First and Last Name Please enter valid data.
    • Male or Female Please enter valid data.
    • Date of Birth Please enter valid data.
    • Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Sacramental

      Check all that apply.

      Baptized First Communion Confirmed Married Sacramental Marriage Attends Religious Formation
    • Present School or Employer Please enter valid data.
    • Currently Attends St. MIchael Academy Yes No
  • Other Information
  • Would You Like to Receive Parish Mailings And Important Information by Electronic Mail? REQUIRED Yes No Both Please fill out this field.

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