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- Family information: Last name REQUIRED Please fill out this field. Please enter valid data.
- Street address including apartment, unit, etc. 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.
- The following questions pertain to just the first adult member of the household. (Information about other household members will be given further down on this form.)
- Information for Family Member 1
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status REQUIRED Married Single Widowed Divorced Please fill out this field.
  
  If married - where did the marriage take place? Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  We would like to add you to our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. REQUIRED Yes, please subscribe me! No thanks, I don't use email. Please fill out this field.
  
  Cell phone Please enter valid data.
  
  Home Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Sacramental information:
  
  What language(s) do you speak at home? REQUIRED Please fill out this field. Please enter valid data.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church. Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
- Were you previously registered at another parish? Is so, what parish and where was it located? REQUIRED Please fill out this field. Please enter valid data.
- Number of additional household members REQUIRED Please fill out this field.
  
  Additional Family Member 1
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 2
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 3
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 4
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 5
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 6
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 7
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 8
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 9
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 10
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 11
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
  
  Additional Family Member 12
  
  Legal first name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred first name REQUIRED Please fill out this field. Please enter valid data.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden name if applicable Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital status Married Single Widow Divorced
  
  Relationship to family member 1 REQUIRED Spouse Child Parent Other relative Other non-relative Please fill out this field.
  
  If school aged - what grade are you currently in?
  
  Occupation if applicable Please enter valid data.
  
  Email Please enter an email address.
  
  Would you like this email to receive our weekly email newsletter (very short email about important parish news). You can unsubscribe at any time. Yes, please subscribe me! No thanks, I don't use email.
  
  Cell phone Maximum 20 characters Please enter a phone number.
  
  Were you baptized? REQUIRED No, I have not been baptized. Yes, I was baptized Catholic. Yes, I was baptized in another religion. Please fill out this field.
  
  Have you celebrated first communion? REQUIRED No Yes, in the Catholic Church Yes, I have received communion in a church of another denomination. Please fill out this field.
  
  Were you confirmed? REQUIRED No, I have not been confirmed. Yes, I was confirmed Catholic. Yes, I was confirmed in another religion. Please fill out this field.
- One way we welcome new members to the parish is by listing their name in our weekly bulletin. Are you okay having your name(s) listed? REQUIRED Yes, that's fine. No, I/we prefer not to have the names listed in the bulletin. Please fill out this field.
- Another way we welcome new members is by having a member of our welcome committee give them a call. Yes, that would be great. I am okay with you giving them my number. No, I prefer not to have a welcome committee volunteer call me, thanks anyway.
- On behalf of your household, how would you like to handle any donations you might make to St. Tim's? REQUIRED Please send me packets of envelopes to use. I prefer to give electronically and will set that up on the donations page of the St. Tim's website, so I don't need any envelopes. I want to set up electronic giving and need help doing that. None of the above. Please fill out this field.
- Although our bulletin can be picked up in church or viewed on our website, we also will mail it to you. Are you interested in this? Yes, please contact me regarding having the bulletin mailed to me. No thanks, I can pick it up or see it online.
- Would you like more information about any of the following? Check all that apply. Volunteer opportunities Faith formation for children/youth Faith formation opportunities for adults Social justice activities Bible study groups Young adult activities Youth group/activities Pastoral care Baptism
- How did you hear about St. Timothy's? REQUIRED Convenient location Grew up at St. Timothy's Personal invitation Online (website, Facebook, YouTube, etc) Word of mouth Other Please fill out this field.
- If you selected "other" above, please describe below:
- Is there anything else you would like us to know about you and/or your family? Are there any specific needs you have?
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