Our Lady of Fatima
Catholic Church
Household Registration
Family Name:
Address:
City:
State:
Zip:
Home Phone (with area code):
Primary email:
Permission to publish address and phone in Parish Directory?
Please select method for contributing to the Sunday offertory:
Electronic Funds Transfer (EFT) from bank account or credit card
Envelopes for weekly offertory
Role (select one)
First Name / Nickname:
Work Phone / Cell Ph:
Email:
DOB (mm/dd/yy):
Gender:
First Language:
Occupation:
Sacramental Info:
Check if Sacrament
Received
Would you like someone to contact you regarding sacramental needs?
Use the following section for dependent children and additional family members.
Children/Additional Family Members (living in household)
Relationship First Name Last Name Birthdate School/Grade
(if applicable)
1
2
3
4
5
6
Sacramental Info:
Check if Sacrament
Received
Sacramental Info:
Check if Sacrament
Received
Sacramental Info:
Check if Sacrament
Received
Sacramental Info:
Check if Sacrament
Received
Sacramental Info:
Check if Sacrament
Received
Sacramental Info:
Check if Sacrament
Received
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