Parish Registration Form

Print off and mail to Parish Office (PO. 137, Kimball, SD 57355) or bring to church and put in offering basket.

Last Name:___________________________________________________________________

 

First Name:___________________________________________________________________

 

Spouse First Name__________________________Maiden Name_______________________

 

Address_____________________City________________State__________Zip Code________

 

Home Phone #_____________________Work Phone #________________________________

 

Manís place of employment______________________________________________________

 

Womanís place of employment___________________________________________________

 

Retired:yes____________No______________

 

Marriage date & where__________________________________________________________


 


Manís information:

 

Date of Birth__________________________________

 

Religion______________________________________

 

Baptism:Yes___No_____ Where____________________________Date___________

First Communion:†† Yes___No_____ Where____________________________Date___________

Confirmation: Yes____No____ Where____________________________Date___________

 

Occupation__________________________________

 

Womansís information:

 

Date of Birth__________________________________

 

Religion______________________________________

 

Baptism:Yes___No_____ Where____________________________Date___________

First Communion:Yes___No_____ Where____________________________Date___________

Confirmed: Yes____No____ Where____________________________Date___________

 

Occupation_________________________________

 

Please list all children:

First Child:

Name:__________________________________

Male/Female†† Date of birth________________

Baptism (date/where) ______________________

1st Communion(date/where)_________________

Confirmation (date/where)_________________

School grade: ____________________________

 

Second Child:

Name:__________________________________

Male/Female†† Date of birth________________

Baptism (date/where) ______________________

1st Communion(date/where)_________________

Confirmation (date/where)__________________

School grade: ____________________________

 

Third Child:

Name:__________________________________

Male/Female†† Date of birth________________

Baptism (date/where) ______________________

1st Communion(date/where)________________

Confirmation (date/where)__________________

School grade: ____________________________

 

 

Fourth Child:

Name:___________________________________

Male/Female†† Date of birth________________

Baptism (date/where) ______________________

1stCommunion(date/where)_________________

Confirmation (date/where)__________________

School grade: ____________________________

 

 

Fifth Child:

Name:__________________________________

Male/Female†† Date of birth________________

Baptism (date/where) ______________________

1st Communion(date/where)_________________

Confirmation (date/where)__________________

School grade: ____________________________