St. Albert the Great - Registration Form Date Of Registration Household Last Name * Address City Zip Code Home Phone * Unlisted NoYes Adult Male Registration First Name Middle Name Preferred First Name Birth Date Religion CatholicOther Other (Specify) Sacraments Received Bapism First Communion Penance Confirmation Matrimony Marital Status DivorcedMarriedSeparatedSingleWidowed Employer Occupation Cell Phone EMail Adult Female Registration First Name Middle Name Preferred First Name Birth Date Religion CatholicOther Religion (Other) Sacraments Received Bapism First Communion Penance Confirmation Matrimony Marital Status DivorcedMarriedSeparatedSingleWidowed Maiden Name Occupation Employer Cell Phone EMail Marriage If Married, Date Of Marriage Name of Church City & State Married Catholic NoYes If No to the above question, would you like to talk to a priest? First Child Name Gender Birthdate Religion Attended Rel Ed Classes NoYes Sacraments Received Bapism First Communion Penance Confirmation Matrimony School Grade Second Child Name Birthdate Gender Religion Attended Rel Ed Classes NoYes Sacraments Received Bapism First Communion Penance Confirmation Matrimony School Grade Third Child Name Gender Birthdate Religion Attended Rel Ed Classes NoYes Sacraments Received Bapism First Communion Penance Confirmation Matrimony School Grade Fourth Child Name Gender Birthdate Religion Attended Rel Ed Classes NoYes Sacraments Received Bapism First Communion Penance Confirmation Matrimony School Grade Additional Information Emergency Contact Emergency Contact No Does anyone in your household have any special needs? Name: Special Needs Physical Handicap Mental Handicap Homebound Nursing Home If nursing home, name of nursing home Comments Contribution Method Contribution Envelopes Please send information on electronic giving OUR WELCOMING COMMITTEE WOULD LIKE TO VISIT YOU AND BRING A GIFT AND FURTHER INFORMATION ABOUT THE PARISH. Would this be agreeable to you? NoYes * - Indicates a Required Field