ST



ST. JOSEPH CATHOLIC CHURCH

108 St. Joseph Street / PO Box 220

Kannapolis, NC 28083

(704) 932-4607 / Fax # (704) 932-0566

PARISH REGISTRATION FORM

Name and City/State of Previous Parish _____________________________________________

Title: Mr. & Mrs. Mr. Mrs. Miss Ms. Dr. Dr. & Mrs.

Last Name: ___________________________ Wife’s Maiden Name _____________________

Address: _____________________________________________________________

City __________________________ State ______ Zip Code _________

Telephone #: _______________________ Unlisted Number: Y or N?

E-Mail Address: ____________________________________________________________

Head of Family – First Name - ___________________________

Occupation: _______________________ Business Phone: ____________________

Birth Date: ____________________ Religion:_____________________

Marital Status: ________________ Date of Marriage: _____________

Other Languages Spoken: _____________________________

Handicap: __________________________________________

Sacraments received: Baptism ___ First Communion ___ Confirmation ___

Spouse – First Name- __________________________________

Occupation: ______________________ Business Phone:_____________________

Birth Date: ______________________ Religion: __________________________

Marital Status: ___________________ Date of Marriage: ___________________

Other Languages Spoken: _____________________________________________

Handicap:__________________________________________________________

Sacraments received: Baptism ___ First Communion ___ Confirmation ___

Please fill out the following information for children living in your household

NAME SEX DOB SACRAMENTS RECEIVED

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

_______________________ ___ ________ ________________________________

Is there a shut-in living in the home? ________________

COMMENTS/SUGGESTIONS:

After completion, please return this form to the Parish Office at the address on the other

side, or you may drop it in the collection plate on Sunday.

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