“In the evening of life we will be judged by love.”
New Member Form
About Your Family
*
Family Name:
*
Street Address:
*
Apt #:
City:
*
State:
*
Zip:
*
Home Phone Number:
*
About You
*
Title:
*
Select One
Dr.
Mr.
Mrs.
Ms.
Mr. and Mrs.
Mr. and Ms.
Last Name:
*
First Name:
*
Date of Birth:
*
Email:
*
Cell Number:
Religion:
Sacraments Received
Baptism
Communion
Confirmation
Marital Status:
Select One
Married
Seperated
Single
Widowed
Divorced
Valid Catholic Marriage
Civil/Non-Catholic Marriage
Date of Marriage:
Church/Place of Marriage:
Occupation:
About You (Adult 2)
Title:
Select One
Dr.
Mr.
Mrs.
Ms.
Mr. and Mrs.
Mr. and Ms.
First Name:
Last Name:
Date of Birth:
Email:
Cell Number:
Religion:
Sacraments Received:
Baptism
Communion
Confirmation
Occupation:
About Your Children
Total # of children in your household:
Child #1
Name:
Sex:
Select One
Male
Female
Date of Birth:
Grade Completed:
Select One
1
2
3
4
5
6
7
8
9
10
11
12
College
Religion:
Sacraments Received:
Baptism
First Reconciliation
Communion
Confirmation
Date of Baptism:
Date of First Reconciliation:
Date of Communion:
Date of Confirmation:
Child #2
Name:
Sex:
Select One
Male
Female
Date of Birth:
Grade Completed:
Select One
1
2
3
4
5
6
7
8
9
10
11
12
College
Religion:
Sacraments Received:
Baptism
First Reconciliation
Communion
Confirmation
Date of Baptism:
Date of First Reconciliation:
Date of Communion:
Date of Confirmation:
Child #3
Name:
Sex:
Select One
Male
Female
Date of Birth:
Grade Completed:
Select One
1
2
3
4
5
6
7
8
9
10
11
12
College
Religion:
Sacraments Received:
Baptism
First Reconciliation
Communion
Confirmation
Date of Baptism:
Date of First Reconciliation:
Date of Communion:
Date of Confirmation:
Child #4
Name:
Sex:
Select One
Male
Female
Date of Birth:
Grade Completed:
Select One
1
2
3
4
5
6
7
8
9
10
11
12
College
Religion:
Sacraments Received:
Baptism
First Reconciliation
Communion
Confirmation
Date of Baptism
Date of First Reconciliation
Date of Communion
Date of Confirmation
How Can We Better Serve You?
Do you or someone in your family have special needs? (Please specify, please include the special needs individual's name)
If yes, may someone from the appropriate Parish Ministry contact you?
Select One
Yes
No
Do you have other family or non-family members living in your household? (Ex: grandparent, aunt, uncle, niece, etc.)Please list their name and relation:
Interest Survey
Please check the Organization or Ministry you or a family member might be interested in learning more about or joining. Check any that apply and indicate to whom they apply.
Altar Commitee
Altar Server
Art & Environment Committee
Baptism Preparation Committee
Bereavement Minister
Career Networking Group
Children's Choirs
Children's Liturgy of the Word Leader
Choir Member
Communion Minister
Crossroads Teen Ministry Home Group Leader
Crossroads Teen Ministry Event Volunteer
Crossroads Advisory Board
Eucharistic Adoration Leader
Finance Council
Food Pantry Committee
Gardening Angels
Harvest Saturday Committee
Lector
Men's Club
Minister of Care to Sick and Homebound
New Parishioner Ministry
Ourteach Advisory Committee
Parish Hospitality Committee
Prayer Shawl Ministry
Resurrection Choir Member
Respect Life Committee
Senior Club
Share Christmas Committee
Sharing Parish Outreach
School Advisory Board
Teen Choir
Wedding Coordinator
Women's Club
Young Mothers’ Circle of Friends Club
Youth Catechesis Advisory Board
Youth Catechesis Teacher
Are there other organizations or ministries that you would like to see at our parish? Please specify.
Special Skills
Do you or does someone in your family have special skills that they might be willing to share with our parish community?
Were you a registered parishioner at St. John of the Cross Parish in the past?
Select One
Yes
No
If yes, approximately when:
What name were you registered under?
From time to time we list the names of our new parishioners as a way to welcome them. Is it ok to list your name?
Select One
Yes
No
Parish Photo Directory
Would you like your name and address to be listed in our parish directory?
Select One
Yes
No
Would you like your phone number listed?
Select One
Yes
No
Picture Release
SJC has permission to use my picture and pictures of my family from church events in the parish bulletin and website.
Select One
Yes
No
Parish eNewsletter & Bulletin
Would you like to receive our e-newsletter and weekly parish bulletin? If yes, please provide the email address you'd like it to go to:
Select One
Yes
No
Email
Validation in progress
