Divine Word Parish Registration Form

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* 1. May we publish your contact information in our parish directory?

Yes

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* 2. Last Name of Family / Registrant

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* 3. Mailing Address

Street / PO Box

City

Zip

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* 4. Communication Information

Home Phone

Cell Phone 1

Cell Phone 2

Email 1

Email 2

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* 5. Male Adult in Household

First Name

Nickname/Goes by Name

Birthday (M/D/Y)

Marital Status (Single/Married/Widowed/Divorced)

Church of Baptism (Name, City, State)

Date of Baptism

Date of Confirmation

Date of First Communion

Date of Marriage (if applicable)

Church of Marriage (if married)

Occupation/Employer

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* 6. Female Adult in Household

First Name

Nickname/Goes by Name

Birthday (M/D/Y)

Marital Status (Single/Married/Widowed/Divorced)

Church of Baptism (Name, City, State)

Date of Baptism

Date of Confirmation

Date of First Communion

Date of Marriage (if applicable)

Church of Marriage (if married)

Maiden Name (if applicable)

Occupation/Employer

If you have children in your household, please provide information about each child.

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* 7. Child #1

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade

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* 8. Child #2

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade

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* 9. Child #3

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade

NOTE: If you have additional children, they may be added later on this form.

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* 10. Please contact me about using my talents in the following parish ministries (check all that apply). Contact the Parish Office at 440-256-1412 for additional information about our various ministries.

Altar Server

Art & Environment

Children's Liturgy of the Word

Extraordinary Minister of Holy Communion

Lectoring

Music Ministry

Sacristans

Usher/Greeter

Adoration

Adult Education

Bible Study

Prayer Shawl Ministry

High School Ministry

Junior High Ministry

Pre-Baptism Classes

Pre-Cana

RCIA

Sacramental Programs

Vacation Bible School

Youth Faith Formation

Joseph House Ministry

Sunday Meals Program

Society of St. Vincent de Paul

Parish Life Commission

Finance Council

Buildings & Grounds Committee

Holy Name Society

Our Lady's Guild

Parish Pastoral Council

Bereavement

Avilas

Money Counting

Office Work

Reverse Raffle Fundraising

Thank you for registering with our parish and WELCOME! (If you have additional children, please provide information about each additional child below.)

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* 11. Child #4

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade

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* 12. Child #5

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade

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* 13. Child #6

Name

Male or Female

Birthdate

Date and Church of Baptism

Confirmation and First Communion Completed?

School and Grade