Parish Registration

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First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Mailing Address (Street/P.O. Box) REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Other Phone Number Maximum 20 characters Please enter a phone number.
Primary Email REQUIRED Please fill out this field. Please enter valid data.
Other Emails Please enter valid data.
Family Type - Please select one REQUIRED 2 - parent family with minor children 1 - parent family with minor children Individual residing alone Family with adult children at home 2 or more adults living at same address Married couple with no children at home Other Please fill out this field.
Primary Adults in Household
- Full Name (first, middle, maiden, last) REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Age: Please enter valid data.
- Sacraments Received REQUIRED Baptism Communion Confirmation Please fill out this field.
- RCIA Yes No
- Marital Status - select one REQUIRED Please fill out this field.
- Primary language spoken in household: Please enter valid data.
- Religion, if not Catholic: Please enter valid data.
- Do you have special needs/disabilities that will help us know how to serve you? If so, please state: Please enter valid data.
- Education: Highest grade/degree completed Please enter valid data.
- Employment Position/Type of Work: Please enter valid data.
- Other Primary Adult in Household REQUIRED Please fill out this field.
- Other Adult 1
  - Full Name (first, middle, maiden, last) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Age Please enter valid data.
  - Sacraments Received REQUIRED Baptism Communion Eucharist Please fill out this field.
  - RCIA Yes No
  - Marital Status - select one
  - Primary language spoken in household: Please enter valid data.
  - Religion, if not Catholic: Please enter valid data.
  - Do you have special needs/disabilities that will help us know how to serve you? If so, please state: Please enter valid data.
  - Education: Highest grade/degree completed Please enter valid data.
  - Employment Position/Type of Work: Please enter valid data.
- All Other Members of your Household (not registered separately as parishioners) REQUIRED Please fill out this field.
- Member 1
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 2
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 3
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 4
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 5
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 6
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 7
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 8
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 9
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.
- Member 10
  - Name (first and middle, include last name if different from adults) REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Please fill out this field.
  - Present School/Employer Please enter valid data.
  - Sacraments Received: REQUIRED Baptism Communion Confirmation Please fill out this field.
  - Special Needs/Disabilities Please enter valid data.

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Our Mother of Sorrows/
St. Peter the Apostle Parish

Centreville, MD

Parish Registration

Online Parish Registration Form