Parishioner Registration Form

St. John the Baptist Catholic Church

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Parishioner Registration Form

Welcome to our New Member Registration Page!
We are so glad you stopped by! If you have any questions or issues filling out the form, please contact our rectory staff at 618-282-3222 and we will be happy to assist you or answer any questions you might have.

St. John The Baptist Catholic Church Red Bud IL - Online Registration Form

New Parishioner Family Information

* Indicates required field

Last Name of New Member(s) *

Street Address *

City *

State *

Zip *

Phone Number *

Email *

Individual Member Information

Head of Household *

First

Last

Maiden Name *

Choose One *

Male Female

Date of Birth mm/dd/yyyy *

Email *

Cell Phone *

Occupation / Employer *

Work Phone *

Religion *

Convert? *

Yes No

Baptized? *

Yes No

If Baptized, please provide Church, City and State *

First Communion? *

Yes No

Confirmed? *

Yes No

Marital Status *

If married, please provide date of marriage *

If married, please provide Church, City and State *

Spouse Information

Spouse Name *

First

Last

Maiden Name *

Choose One *

Male Female

Date of Birth mm/dd/yyyy *

Email *

Cell Phone *

Occupation / Employer *

Work Phone *

Religion *

Convert? *

Yes No

Baptized? *

Yes No

If Baptized, please provide Church, City and State *

First Communion? *

Yes No

Confirmed? *

Yes No

1. Children/Others Living in Household

1. Name *

First

Last

1. Relationship *

1. Choose One *

Male Female

1. Birthdate mm/dd/yyyy *

1. Religion *

1. Baptized? *

Yes No

1. If Baptized, please provide Church, City and State *

1. First Communion? *

Yes No

1. Confirmed? *

Yes No

2. Children/Others Living in Household

2. Name *

First

Last

2. Relationship *

2. Choose One *

Male Female

2. Birthdate mm/dd/yyyy *

2. Religion *

2. Baptized? *

Yes No

2. If Baptized, please provide Church, City and State *

2. First Communion? *

Yes No

2. Confirmed? *

Yes No

3. Children/Others Living in Household

3. Name *

First

Last

3. Relationship *

3. Choose One *

Male Female

3. Birthdate mm/dd/yyyy *

3. Religion *

3. Baptized? *

Yes No

3. If Baptized, please provide Church, City and State *

3. First Communion? *

Yes No

3. Confirmed? *

Yes No

4. Children/Others Living in Household

4. Name *

First

Last

4. Relationship *

4. Choose One *

Male Female

4. Birthdate mm/dd/yyyy *

4. Religion *

4. Baptized? *

Yes No

4. If Baptized, please provide Church, City and State *

4. First Communion? *

Yes No

4. Confirmed? *

Yes No

Comments *

Submit

Home
Bulletins/Calendar
Events
Faith Formation
Parish School of Religion (PSR)
Parish Groups
Liturgical Involvement/Schedules
Choirs
- Choirs
Sacraments
Parish Center
News
History
Links
Parishioner Registration Form