Parish Registration

519 Longmeadow Street
Longmeadow, MA 01106

413-567-3124

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Parish Registration

New Parishioner Registration

We're so happy that you've chosen to join our parish family!

Parish Registration Form

Family Surname

Date

Street Address

City

State

Zip

Do you live in the area year round or seasonally?

Year Round

Seasonally

I/ We would like to participate in Online Giving

Yes

No

1st Head of Household - First Name

1st Head of Household - Last Name

Date of Birth

1st Head of Household

Male

Female

1st Head of Household - Marital Status

Single

Married

Separated

Divorced

Widowed

Maiden Name

1st Head of Household - Primary Phone Number

Email Address

Receive Parish Emails?

Yes

No

1st Head of Household - Religion

Sacraments Completed

Baptism

First Communion

Confirmation

Baptism Date

Baptism- Church, City, State

Marriage Date

Marriage - Church, City, State

Occupation

Additional Notes (If Applicable)

2nd Head of Household - First Name

2nd Head of Household - Last Name

Date of Birth

New Field:

Male

Female

2nd Head of Household - Marital Status

Single

Married

Separated

Divorced

Widowed

Maiden Name (If Applicable)

2nd Head of Household-Primary Phone Number

Email Address

Receive Parish Emails?

Yes

No

2nd Head of Household - Religion

Sacraments Completed

Baptism

First Communion

Confirmation

Baptism Date

Baptism-Church, City, State

Occupation

Additional Notes (If Applicable)

Free Text

Additional Household/Family Members

First Name, Middle Initial, Last Name

Date of Birth

M/F

Male

Female

Religion

Sacraments Completed

Baptism

First Communion

Confirmation

Relationship to Head of Household

Baptism

Baptism- Church, City, State

Additional Notes

First Name, Middle Initial, Last Name

Date of Birth

Field label

Male

Female

Religion

Sacraments Complete

Baptism

First Communion

Confirmation

Relationship to Head of Household

Baptism

Baptism- Church, City, State

Additional Notes:

First Name, Middle Initial, Last Name

Date of Birth

New Field:

Male

Female

Religion

Sacraments Completed

Relationship to Head of Household

Baptism-Church, City, State

Additional Notes:

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Our Location

519 Longmeadow Street
Longmeadow, MA 01106

413-567-3124

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