Parishioner Registration

ST. MARY'S CATHOLIC CHURCH

ABOUT
SACRAMENTS
FORMATION
HEALING
STEWARDSHIP
DONATE
NEWS & EVENTS

ABOUT
SACRAMENTS
FORMATION
HEALING
STEWARDSHIP
DONATE
NEWS & EVENTS

Search

Register to be a Parishioner

* Indicates required field

Family Last Name *

Phone *

Please include area code.

Address *

Email *

City *

Zip *

Church Support *

ADULT 1

FIRST NAME *

MIDDLE NAME *

LAST NAME *

Maiden Name (If applicable) *

Gender *

Cell Number *

Please include area code.

Date of Birth *

MARK ALL SACRAMENTS COMPLETED IN THE CATHOLIC CHURCH *

Baptism Holy Communion Confirmation Matrimony None

ADULT 2

FIRST NAME *

MIDDLE NAME *

LAST NAME *

Maiden Name (If applicable) *

Gender *

Cell Number *

Please include area code.

Date of Birth *

MARK ALL SACRAMENTS COMPLETED IN THE CATHOLIC CHURCH *

Baptism Holy Communion Confirmation Matrimony None

Please fill out the following information if you have children living at home.

CHILD 1

FIRST NAME *

MIDDLE NAME *

LAST NAME *

School Attending *

GRADE *

Gender *

Date of Birth *

SACRAMENTS COMPLETED *

Baptism First Communion Confirmation

CHILD 2

FIRST NAME *

MIDDLE NAME *

LAST NAME *

School Attending *

Grade *

Gender *

Date of Birth *

Sacraments Completed *

Baptism First Communion Confirmation

CHILD 3

FIRST NAME *

MIDDLE NAME *

LAST NAME *

School Attending *

Grade *

Gender *

Date of Birth *

Sacraments Completed *

Baptism First Communion Confirmation

CHILD 4

FIRST NAME *

MIDDLE NAME *

LAST NAME *

School Attending *

Grade *

Gender *

Date of Birth *

Sacraments Completed *

Baptism Holy Communion Confirmation

Additional Family Members *

Submit

ST. MARY'S CATHOLIC CHURCH
FR. JOSEPH BAKER, PASTOR
119 E. HOWARD ST., PONTIAC, IL 61764
PHONE (815) 844-7683
FAX (815) 844-6987

ABOUT
SACRAMENTS
FORMATION
HEALING
STEWARDSHIP
DONATE
NEWS & EVENTS