Family Name *

Home Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Home Email *

Preferred Contact Method *

Phone
Email
Text Message

Previous Parish

Family/ individual digital picture

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Adult 1

Full Name *

Email *

Ethnic Group

Gender

Marital Status *

Marriage Date

day/month/year

Occupation

Place of Employment

Work Phone

Cell Phone *

Date of Birth *

Religion *

I am interested in the possibility of becoming Catholic:

Sacraments received:

Baptism
Reconciliation
Eucharist
Confirmation

Adult 2

Ethnic Group

Gender

Full Name

Marital Status

Marriage Date

Occupation

Place of Employment

Work Phone

Cell Phone

Date of Birth

Religion

I am interested in the possibility of becoming Catholic:

Sacraments received:

Baptism
Reconciliation
Eucharist
Confirmation

Additional family members at this address?

Full Name

Gender

Date of Birth

Grade

School Attending

Sacraments Received

Baptism
Reconciliation
Eucharist
Confirmation

Additional members at this address?

Full Name

Gender

Date of Birth

Grade

School Attending

Sacraments Received

Baptism
Reconciliation
Eucharist
Confirmation

Full Name(s)

Social Action:

Refugee Resettlement (working with Catholic Charities)
Social Action Committee or projects
Habitat for Humanity (many opportunities for involvement in the Rochester Area Habitat for Humanity mission)
Family Promise (serving families in need)
Sunday Lunch Program serving those in need
Society of Saint Vincent de Paul (A Catholic lay organization where men and women come to grow spiritually through serving those in need)
Care for Creation Team

Full Name(s)

Services to the Parish:

Child Care (variety of opportunities depending upon parish activities)
Homebound (visit and/or take communion to members of our parish who are unable to come to Mass)
Driver (take homebound to Mass or parish events)
Photographer (cover parish celebrations)
Grounds Keeping ( help keep the surrounding grounds in good condition)
Parish Office Help (answ ering phones, preparing mailings, etc.)

Full Name(s)

Special Services:

Funeral Lunch (help serve lunch/ refreshments after funerals)
Reception Helper ( help set-up, serve and/or provide treats for special receptions)
Funeral Hospitality ( w elcome inside/ outside before service)
Clean Up (help clean up after special events)
Special events ( example: Pot Lucks, Social Gatherings, New Parishioner gathering, etc.)

Full Name(s)

Adult 1

Adult 2

We encourage participation in the parish for all parishioners. Please indicate ministries of interest by placing the individual’s name on the line provided, feel free to call for more information at 507-288-7372: