Church of the Assumption Online Registration and Update Form.
Please fill out the form as completely as possible
and click on the Submit button when finished.

General Family Information

Please choose one:

 

Family Name: 

Street Address:

City, State, Zip Code 

Telephone Number: 

Family Email Address: 

Languages Spoken at Home: 

Years in this Parish: 

Family Residence: 

Head of Household: 

Note to the Parish Office: 

Adult One
Name (Include preferred title):
Maiden Name: 
Date of Birth:
Country of Birth:
Religion:
Has Adult 1  received the Sacrament of Baptism?  YesNo
Has Adult 1  received the Sacrament of Eucharist? YesNo
Has Adult 1  received the Sacrament of Confirmation?  YesNo
Mass Attendance (choose one):
To which church organizations does Adult 1 belong?

School or Occupation:

Click when finished with entire form.

Adult Two
Name (Include preferred title):
Maiden Name: 
Date of Birth:
Country of Birth:
Religion:
Has Adult 2  received the Sacrament of Baptism?  YesNo
Has Adult 2  received the Sacrament of Eucharist? YesNo
Has Adult 2  received the Sacrament of Confirmation?  YesNo
Mass Attendance (choose one):
To which church organizations does Adult 2 belong?

School or Occupation:

Click when finished with entire form.

Child One
Name:
Date of Birth:
Country of Birth:
Religion:
Has child 1 received the Sacrament of Baptism? Yes    No
Has child 1 received the Sacrament of Eucharist?  Yes    No
Has child 1 received the Sacrament of Confirmation? Yes    No
Mass Attendance (choose one):
To which church organizations does child belong?
School:

Click when finished with entire form.

Child Two
Name:
Date of Birth:
Country of Birth:
Religion:
Has child 2 received the Sacrament of Baptism? Yes    No
Has child 2 received the Sacrament of Eucharist?  Yes    No
Has child 2 received the Sacrament of Confirmation? Yes    No
Mass Attendance (choose one):
To which church organizations does child  belong?
School:

Click when finished with entire form.

Child Three
Name:
Date of Birth:
Country of Birth:
Religion:
Has child 3 received the Sacrament of Baptism? Yes    No
Has child 3 received the Sacrament of Eucharist?  Yes    No
Has child 3 received the Sacrament of Confirmation? Yes    No
Mass Attendance (choose one):
To which church organizations does child belong?
School:

Click when finished with entire form.

Child Four
Name:
Date of Birth:
Country of Birth:
Religion:
Has child 4 received the Sacrament of Baptism? Yes    No
Has child 4 received the Sacrament of Eucharist?  Yes    No
Has child 4 received the Sacrament of Confirmation? Yes    No
Mass Attendance (choose one):
To which church organizations does child belong?
School:

Click when finished with entire form.

If you have more than four children, God Bless You!  
Please e-mail us the information about your remaining gifts from God, or call the parish office.

office@churchoftheassumption.com

Parish Office: 609-758-2153