A Parish of the Roman Catholic Diocese of Charlotte.- Diocese founded: 1972

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PARISH REGISTRATION FORM

- PARISH REGISTRATION
  - PARISH REGISTRATION FORM

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- WELCOME! BIENVENIDO!
- Would you like parish Offertory Envelopes? Quieres parish Offertory Envelopes? REQUIRED YES, please! Si, por favor. Offertory envelopes are a great way to show my financial support of my new parish family! No, thanks. No, gracias. Please fill out this field.
- Family Last Name/Apellido de la familia REQUIRED Please fill out this field. Please enter valid data.
- Mailing Address/Direccion de envio 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.
- HEAD OF HOUSEHOLD (Jefe de Familia) REQUIRED Please fill out this field. Please enter valid data.
- DOB/ Fecha de nacimiento) REQUIRED Please fill out this field. Please enter valid data.
- Phone Number/telefono REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email(correo electronico) REQUIRED Please fill out this field. Please enter an email address.
- SPOUSE (First Name & MAIDEN Name)/ ESPOSA (Nombre y Nombre de soltera) REQUIRED Please fill out this field. Please enter valid data.
- DOB/ Fecha de nacimiento) REQUIRED Please fill out this field. Please enter valid data.
- Phone Number/telefono REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email(correo electronico) REQUIRED Please fill out this field. Please enter an email address.
- NAMES OF CHILDREN LIVING WITH YOU/ Nombres de los ninos que viven contigo
- CHILD #1/ NINO Numero 1 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- CHILD #2/ NINO Numero 2 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- CHILD #3/ NINO Numero 3 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- CHILD #4/ NINO Numero 4 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- CHILD #5/ NINO Numero 5 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- CHILD #6/ NINO Numero 6 Please enter valid data.
- DOB/ Fecha de nacimiento) Please enter valid data.
- Phone Number/telefono Maximum 20 characters Please enter a phone number.
- Email(correo electronico) Please enter an email address.
- SACRAMENTS NEEDED? / SACRAMENTOS NECESARIOS (SI LOS HAY) REQUIRED Please fill out this field.
- If "yes", please list the person(s) and which Sacrament(s) are needed/ En caso afirmativo, enumere el nombre de la persona y que Sacramento se necesita
- IMPORTANT NOTE:
  If there are any other adults (over 21) in the household who are NOT THE SPOUSE of the Head of Household, they must be a SEPARATE HOUSEHOLD, complete a form and be registered on their own. Thank you.
  
  Nota importante:
  Si hay otros adultos (mayores de 21 anos) en el hogar que NO sean conyuges del Jefe de Hogar, deben ser un HOGAR SEPARADO, completar un formulario y estar registrados por su cuenta. Muchas gracias!
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St Francis of Assisi
Catholic Church

Mocksville, North Carolina

PARISH REGISTRATION FORM