New Member Pre-Registration Options

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New Member Pre-Registration Options

PRINT PRE-REGISTRATION FORM PLEASE BRING OR MAIL COMPLETED FORM TO ST. PATRICK AND WE WILL CONTACT YOU FOR AN ORIENTATION.

OR

PRE-REGISTER ONLINE – WE WILL CONTACT YOU TO ATTEND OUR NEXT ORIENTATION.

New Member PRE-Registration

Preferred Mass time*
Address*
Street Address Address Line 2 City State ZIP Code
Head of Household - Personal Information*
First Middle Last
Maiden name if applicable
Date of Birth*
MM slash DD slash YYYY
Religious Denomination*
Gender*
Current employer*
position*
Email*
Cell Phone*
Sacraments Received*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Marital Status*
- Single
- Married
- Widow
Date of Marriage*
MM slash DD slash YYYY
Spouse - Personal Information*
First Middle Last
Was your current marriage celebrated in the Catholic Church?*
- yes
- no
Would you like Fr. Yanta to contact you with informaton about having your marriage blessed (convalidated?)*
- yes, please.
- Maybe later
- No, thank you
Maiden Name*
Date of Birth*
MM slash DD slash YYYY
Religious Denomination*
Gender*
Current employer*
position*
Email*
Cell Phone*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a child to register?*
Child*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a second child to register?*
Second Child Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a third child to register?*
Third child's name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a forth child to register?*
Child Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a fifth child to register?*
Fifth Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a sixth child to register?*
Sixth Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade for 2016 School Year*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have a seventh child to register?*
Seventh Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Do you have an eight child to register?*
Eight Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Grade*
Sacraments Received (Please supply Certificate of Baptism)*
- Baptism
- First Reconciliation (Confession)
- First Eucharist
- Confirmation
- No Sacraments Received
Please check all that apply
Home Phone*
From a volunteer stand-point, I am interested in becoming*
Our community has so much to offer - Please share with us your reason(s) for choosing St. Patrick!*
How can we pray for you

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19921 Nightingale Street NW
Oak Grove, MN 55011

Office Hours: M-F 8:30 AM - 5:00 PM
Summer Hours: Closed at noon on Fridays

Phone: (763) 753-2011
Email: stpats@st-patricks.org

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