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  Register as a Parishioner at Holy Cross
  
  Head of Household
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address 2 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  How would you like to receive periodic parish updates? (via Flocknote) REQUIRED Email Text Message Neither Please fill out this field.
  
  Please select your preferred tithing option REQUIRED Online giving Envelopes Please fill out this field.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Occupation Please enter valid data.
  
  Which Sacraments have you received in the Catholic Church? Baptism First Communion First Reconciliation Confirmation
  
  Marital Status
  
  If married, what was the date of your marriage? Please enter a date.
  
  If married, were you married in a Catholic Church by a Priest and before two witnesses? Yes No Unsure
  
  Number of Additional Family Members REQUIRED 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.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Family Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion Please enter valid data.
  
  Gender Male Female
  
  Which Sacraments has this family member received in the Catholic Church? Baptism First Reconciliation First Communion Confirmation
  
  Occupation (if adult) Please enter valid data.
  
  Marital Status (if adult)
  
  Email (if adult) Please enter an email address.
  
  Receive Email Updates? (via Flocknote) Yes No
  
  Submit
  
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Register as a Parishioner at Holy Cross