Family Registration Form

Welcome to Nativity of Our Lord Parish. I pray that you will find Nativity of Our Lord a
 place of peace and friendship, its people gracious and kind. I hope that you will
 introduce yourself to me some Sunday in the near future so that we might become better
 acquainted and that I might more formally welcome you.

 May the Good Lord bless you and your family.
 
 Father Jim Ciupek - Pastor
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Click Submit Form to send this information to Nativity of Our Lord.
*Required fields
*Family Option  New Family Information  Update Existing Family Information
       ID/Env:  

Head of Household
  Title Suffix
*First Name *Last Name
  Relationship
Birth Date
*Gender Female   Male
Marital Status
*Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1
Send Email Instead of Mail When Possible
Sacraments
  Baptism Date Place
  Reconcil Date Place
  First Comm Date Place
  Confirm Date Place
  Marriage Date Place

  Spouse
  Title Suffix
  First Name Last Name
  Middle Name
  Relationship
Birth Date
  Gender Female   Male
Marital Status
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1
Send Email Instead of Mail When Possible
Sacraments
  Baptism Received Date Place
  Reconcil Received Date Place
  First Comm Received Date Place
  Confirm Received Date Place
  Marriage Received Date Place

Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP

Family Mailing Address
  Line 1
  Line 2
  City
  State
  ZIP

Family Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Email
*Email
Send Email Instead of Mail When Possible

  Member 1 Type
  Title Suffix
  First Name Last Name
  Middle Name Nickname
  Relationship
Birth Date
  Gender Female   Male
Marital Status
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1
Send Email Instead of Mail When Possible
Sacraments
   Baptism Date Place
   Reconcil Date Place
   First Comm Date Place
   Confirm Date Place
   Marriage Date Place


Click Submit Form to send this information to Nativity of Our Lord.
Nativity of Our Lord