Sacred Heart of Jesus

If you are a new parishioner, please fill in as much information on this form as possible. If you are updating your parish records, please fill in the information that has changed.

New or Updating Information:

New parishioner
Updating current information
Remove from parish records

Contact Information:

Your Name
Mailing Address
Apt #
City
State, Zip
Telephone	home
	work ext
	cell
Email
Primary Language Spoken	English Spanish

Family Information:

Name of Head of Household
Birthdate (dd/mm/yyyy)
Sex	Male Female
Marital Status	Church Married Married Single Widowed Engaged Separated Divorced Remarried
Religion	Catholic Non Catholic
Occupation
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No
Marriage	Yes - Year No


Spouse's Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
Occupation
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No
Marriage	Yes - Year No


Child #1 Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
School
Grade
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No

Child #2 Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
School
Grade
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No

Child #3 Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
School
Grade
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No

Child #4 Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
School
Grade
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No

Child #5 Name
Birthdate (dd/mm/yyyy)
Sex	Male Female
Religion	Catholic Non Catholic
School
Grade
Baptism	Yes - Year No
First Eucharist	Yes - Year No
Confirmation	Yes - Year No

If you have more than 5 children, please submit this form and fill in this form again with the additional children, along with your name.

General Information:

Do you have any children presently attending SHJ School? Yes No

Do you currently receive the Catholic Register? Yes No

Do you wish to receive Parish mailings? Yes No

How would you like to contribute finanically to SHJ?

Weekly Envelopes
Monthly Envelopes
Electronic Withdrawal
I do not wish to contribute

If you chose Envelopes, you will receive them in 6-8 weeks.
If you chose Electronic Withdrawal, a form will be sent to you by the business office.

Would you like information on joining a small Church Community? Yes No

Are there any skills or talents you can share as a volunteer, or any committees or ministries that you are interested in joining?

Do you have any comments or questions you'd like to hear back from us about?

Thank you for taking the time to fill out this entire form and registering with Sacred Heart of Jesus! You will receive a confirmation of your registration shortly!