Erie Tri-County Catholic
Family of Parishes

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Parishioner Information Form

- Parish Family Info
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- New Parishioner Registration Yes
- Registered Parishioner Information Update Yes
- Home Parish REQUIRED Please fill out this field.
- Primary Member
  
  Title
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if you do not have a middle name
  
  Sick / Shut-in REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  Province REQUIRED Please fill out this field. Please enter valid data.
  
  Postal Code REQUIRED Please fill out this field. Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- How many other ADULTS are you registering? REQUIRED Please fill out this field.
  
  Other Adult Member 1
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 2
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 3
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 4
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 5
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 6
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 7
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Other Adult Member 8
  
  Please fill out ALL information for all other adults being registered
  
  Title REQUIRED Please fill out this field.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Sick/Shut-In REQUIRED Yes No Please fill out this field.
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Address (if different from above) Please enter valid data.
  
  Apartment # Please enter valid data.
  
  P.O. Box # Please enter valid data.
  
  City Please enter valid data.
  
  Province Please enter valid data.
  
  Postal Code Please enter valid data.
  
  Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- How many children (living at home) are you registering? REQUIRED Please fill out this field.
  
  Child 1
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 2
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 3
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 4
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 5
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 6
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 7
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Child 8
  
  Please fill out ALL information for all children (living at home) being registered
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name(s)* REQUIRED Please fill out this field. Please enter valid data.
  
  *Please type "None" if they do not have a middle name
  
  Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
- Parish Life
  
  Donation Options Online Donation Direct Deposit Offertory Envelopes
- Would you like someone from the Parish Team to follow up with you at this time? REQUIRED Yes No Please fill out this field.
- If Yes, please state the nature of your follow-up so we can connect you with the appropriate team member.
Submit

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