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Parish Registration

Complete and submit the Registration Form below to register as a parishioner at Sacred Heart of Jesus Parish. Enter the Head of Household as Family Member 1. Each family in a multiple family home should register as a separate household. Fields marked with a * are required.

Family Information

Last Name of Family*

Languages Spoken in the Home*

Address

Line 1*

Line 2

City* State* AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code*

Contact Information

Preferred Phone Number

Phone Number* Phone Type* Cell Home Work

Secondary Phone Number

Phone Number Phone Type Cell Home Work

Email Address

Marriage Information (if applicable)

Place of Marriage (Institution, City, State) Year of Marriage 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Maiden Name of Wife

Family Members

Family Member 1 - Head of Household

Name

Prefix* Mr. Mrs. Miss Ms. First Name* Middle Name Last Name* Suffix

Basic Information

Year of Birth* 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Relationship to Head of Household* Self Marital Status* Divorced Married Separated Single Widowed Highest School Grade* None Pre-kindergarten Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th High School Graduate Associate Degree Bachelor's Degree Master's Degree Doctorate

Employment

Employment Status* Disabled Employed Homemaker Retired Student Underage Unemployed Place of Employment (if employed)

Sacraments Received

Baptism* Yes No First Holy Communion* Yes No Confirmation* Yes No

Family Member 2

Name

Prefix Mr. Mrs. Miss Ms. First Name Middle Name Last Name Suffix

Basic Information

Year of Birth 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Relationship to Head of Household Aunt Brother Brother-in-law Cousin Daughter Father Father-in-law Friend Granddaughter Grandfather Grandmother Grandnephew Grandniece Grandson Great-aunt Great-granddaughter Great-grandfather Great-grandmother Great-grandson Great-uncle Husband Mother Mother-in-law Nephew Niece Other (note in Comments) Sister Sister-in-law Son Stepdaughter Stepfather Stepmother Stepson Uncle Wife Marital Status Divorced Married Separated Single Widowed Highest School Grade None Pre-kindergarten Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th High School Graduate Associate Degree Bachelor's Degree Master's Degree Doctorate

Employment

Employment Status Disabled Employed Homemaker Retired Student Underage Unemployed Place of Employment (if employed)

Sacraments Received

Baptism Yes No First Holy Communion Yes No Confirmation Yes No

Family Member 3

Name

Prefix Mr. Mrs. Miss Ms. First Name Middle Name Last Name Suffix

Basic Information

Year of Birth 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Relationship to Head of Household Aunt Brother Brother-in-law Cousin Daughter Father Father-in-law Friend Granddaughter Grandfather Grandmother Grandnephew Grandniece Grandson Great-aunt Great-granddaughter Great-grandfather Great-grandmother Great-grandson Great-uncle Husband Mother Mother-in-law Nephew Niece Other (note in Comments) Sister Sister-in-law Son Stepdaughter Stepfather Stepmother Stepson Uncle Wife Marital Status Divorced Married Separated Single Widowed Highest School Grade None Pre-kindergarten Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th High School Graduate Associate Degree Bachelor's Degree Master's Degree Doctorate

Employment

Employment Status Disabled Employed Homemaker Retired Student Underage Unemployed Place of Employment (if employed)

Sacraments Received

Baptism Yes No First Holy Communion Yes No Confirmation Yes No

Family Member 4

Name

Prefix Mr. Mrs. Miss Ms. First Name Middle Name Last Name Suffix

Basic Information

Year of Birth 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Relationship to Head of Household Aunt Brother Brother-in-law Cousin Daughter Father Father-in-law Friend Granddaughter Grandfather Grandmother Grandnephew Grandniece Grandson Great-aunt Great-granddaughter Great-grandfather Great-grandmother Great-grandson Great-uncle Husband Mother Mother-in-law Nephew Niece Other (note in Comments) Sister Sister-in-law Son Stepdaughter Stepfather Stepmother Stepson Uncle Wife Marital Status Divorced Married Separated Single Widowed Highest School Grade None Pre-kindergarten Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th High School Graduate Associate Degree Bachelor's Degree Master's Degree Doctorate

Employment

Employment Status Disabled Employed Homemaker Retired Student Underage Unemployed Place of Employment (if employed)

Sacraments Received

Baptism Yes No First Holy Communion Yes No Confirmation Yes No

Additional Information

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