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Parish Registration Form

- About

Please click SUBMIT to send your information to Good Shepherd Parish.
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- Please list the Head of Household first.
- Title REQUIRED Please fill out this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Maiden Name, if applicable Please enter valid data.
- Street Address 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.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Religion Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Occupation REQUIRED Please fill out this field. Please enter valid data.
- Language REQUIRED Please fill out this field.
- Marital Status Married Single Separated Divorced
- Sacraments Received Baptism First Communion Confirmation
- Date and Church of Baptism Please enter valid data.
- Date and Church of First Communion Please enter valid data.
- Date and Church of Confirmation Please enter valid data.
- Date and Church/City of Marriage Please enter valid data.
- Number of Additional Family Members REQUIRED Please fill out this field.
  
  Family Member 1
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 2
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 3
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 4
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 5
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 6
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 7
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 8
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 9
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
  
  Family Member 10
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if applicable Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Religion REQUIRED Please fill out this field.
  
  Date and Church of Baptism Please enter valid data.
  
  Date and Church of First Communion Please enter valid data.
  
  Date and Church of Confirmation Please enter valid data.
  
  Relationship Spouse Son Daughter Grandparent Grandchild Other
Submit

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Church of the Good Shepherd

Perryville, MD

Parish Registration Form