Register with Curé of Ars

Family Name (Last Name) REQUIRED Please fill out this field. Please enter valid data.

Street Address 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.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Primary Email Address REQUIRED Please fill out this field. Please enter an email address.

Subscribe to the monthly electronic newsletter? REQUIRED Please fill out this field.

I would like to be included in the Parish Directory (printed version with name, phone and address that is mailed out yearly) REQUIRED Please fill out this field.

I would like to receive offertory envelopes in the mail REQUIRED Please fill out this field.

Previous Parish Please enter valid data.

Man of the Family

Man's First, Middle & Last Name Please enter valid data.
Date of Birth Please enter a date.
Religion Please enter valid data.
Occupation Please enter valid data.
Place of Employment Please enter valid data.
Work Phone Number Maximum 20 characters Please enter a phone number.
Cell Phone Number Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Marital Status Married or Blessed by the Catholic Church Married Other Widowed Single Divorced

Woman of the Family

Woman's First, Middle & Last Name Please enter valid data.
Maiden Name Please enter valid data.
Date of Birth Please enter a date.
Religion Please enter valid data.
Occupation Please enter valid data.
Place of Employment Please enter valid data.
Work Phone Number Maximum 20 characters Please enter a phone number.
Cell Phone Number Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Marital Status Married or Blessed by the Catholic Church Married Other Widowed Single Divorced

Oldest Child Living in the Residence

First & Middle Name (Last if different) Please enter valid data.
Gender Male Female
Date of Birth Please enter a date.
School Name Please enter valid data.
Grade
Sacraments Baptism First Communion First Reconciliation Confirmation

Second Child Living in the Residence

First & Middle Name (Last if different) Please enter valid data.
Gender Male Female
Date of Birth Please enter a date.
School Name Please enter valid data.
Grade
Sacraments Baptism First Communion First Reconciliation Confirmation

Third Child Living in the Residence

First & Middle Name (Last if different) Please enter valid data.
Gender Male Female
Date of Birth Please enter a date.
School Name Please enter valid data.
Grade
Sacraments Baptism First Communion First Reconciliation Confirmation

Fourth Child Living in the Residence

First & Middle Name (Last if different) Please enter valid data.
Gender Male Female
Date of Birth Please enter a date.
School Name Please enter valid data.
Grade
Sacraments Baptism First Communion First Reconciliation Confirmation

Fifth Child Living in the Residence

First & Middle Name (Last if different) Please enter valid data.
Gender Male Female
Date of Birth Please enter a date.
School Name Please enter valid data.
Grade
Sacraments Baptism First Communion First Reconciliation Confirmation

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Register with Curé of Ars

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