Parish Registration Form Parish Registration Form Family Last Name * Mailing Name * Cell Phone Number * Home Number Email * Emergency Contact Name & relationship * Emergency Contact phone number * My family is currently registered at another Catholic Church * YES NO The name of the parish & city/state you will be transferring from? * Couple/Head of Household Information Please give the correct information for the following First Name (s) * Address * Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Marital Status * Single Married Separated Divorced Widowed Do you have children who are living at home with parents * YES NO Do you have a child who was enrolled in religious education or catholic school in your previous parish? YES NO if the family or individual is already registered in a particular parish, they must obtain the permission of their proper pastor in the form of a letter, in order to register in another parish. I would like to receive Contribution Envelopes * YES NO Please allow approx 8 – 10 weeks to receive your first mailing of envelopes. I am interested in registering with Online Giving * YES NO https://giving.parishsoft.com/App/Giving/st140181 Do we have your permission to publish your family name in the “Welcome New Families” section of the bulletin/website? * YES NO Please check all that apply * Call from Clergy Call from Staff Visit for Sick or Homebound Family Member Adult Information Husband/Head * Husband/Head First First Last Last Date of Birth * Ethnicity * Please choose from dropdownWhite/CaucasianBlack/African AmericanHIspanicKoreanVietnameseFilipinoPrefer not to respond First Language * English Spanish OtherOther Second Language English Spanish OtherOther Baptized – Roman Catholic * YES NO Baptized – Other Denomination * I have received the following Sacraments * First Eucharist Confirmation Matrimony Marriage Date * Were you married in a Catholic Church? * YES NO Name of Church, city/state * RCIA * YES NO Occupation Cell Phone * Email * Adult Information Wife * Wife First First Last Name Last Name Wife – Maiden Name * Date of Birth * Ethnicity * Please choose from dropdownWhite/CaucasianBlack/African AmericanHIspanicKoreanVietnameseFilipinoPrefer not to respond First Language * English Spanish OtherOther Second Language English Spanish OtherOther Baptized – Roman Catholic * YES NO Baptized – Other Denomination * I have received the following Sacraments * First Eucharist Confirmation Matrimony RCIA * YES NO Occupation Cell Phone * Email * Children Information Name * Name First First Middle Middle Last Last Gender * Male Female Date of Birth * Place of Birth * Baptized – Roman Catholic * YES NO Reason for selecting No to Baptism * Need to schedule a baptism Other – DenominationOther – Denomination Please email a copy of baptism certificate with raised seal to info@stclarenj.org Has your child received other Sacraments * YES NO My child has received the following Sacraments * First Eucharist Confirmation Please email a copy of First Eucharist certificate with raised seal to info@stclarenj.org Is your child in Grades 1st thru 8th? * YES NO Are you interested in registering your child for any of the following programs? * Guardian Angels Catholic School Faith Formation Program plus1 Add minus1 Remove If you are human, leave this field blank. 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