Online Registration Form&lt;div&gt;For New Members:&lt;/div&gt;&lt;div&gt;&lt;br&gt;&lt;/div&gt;

Family Name REQUIRED Please fill out this field. Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email Please enter an email address.

Home/Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

I would like to become a parishioner at REQUIRED St.James St. Philip Our Lady of Peace Please fill out this field.

I would like to receive personalized contribution envelopes Yes No

I would like more information about online giving. Yes No

HEAD OF HOUSEHOLD INFORMATION:
Please complete all information for the head of household.

First Name Please enter valid data.

Middle Name and Maiden name (if applicable) Please enter valid data.

Last Name Please enter valid data.

Relationship: Head of Household Husband Wife

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Phone Number Please enter a phone number.

Email Please enter an email address.

Sex: Male Female

Marital Status Single Married Divorced Remarried Separated

Religion Catholic Non-Catholic

Employment: Employed Retired Not employed

Sacraments: Baptized Confirmed Married in the Church

Online Registration Form
For New Members: