New Parishioner Registration Form

Email *

First Name *

Last Name *

Home Address *

City/Zip Code *

Primary Email *

Secondary Email *

Main Telephone Number *

Cell Phone/Secondary Phone Number *

Date of Birth *

Religion *

Please indicate all sacraments that you have received:

Baptism

1st Communion

Confirmation

Current occupation/place of employment: *

Which of the following would you like to receive?

Stewardship Packet

Information on Online Giving

Stewardship Envelopes

Catholic AdvanceP

Please call me as I have additional questions.

Would you like to add a spouse or children? *

Yes

No

Relationship to you?

Spouse

Child

Other (please explain)

Other Explanation

If Spouse, Date of Marriage:

Name

First

Last

Date of Birth

Religion

Please indicate all sacraments that they have received:

Baptism

1st Communion

Confirmation

Current occupation/place of employment:

Would you like to add additional members?

Yes

No

Please list your child's (or children's) name, date of birth, grade in school and any sacraments they have received:

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If you are human, leave this field blank.

St. Vincent de Paul Catholic Church
123 N. Andover Road, Andover, KS 67002

Main Office: (316) 733-1423