CAPTCHAWhich statement applies to you?* Joining the Parish for the First Time Updating my Information at the Parish Which Parish would you like to join?*St. Anne – HarrisvilleSt. Catherine – OssinekeSt. Gabriel – Black RiverSt. Raphael – MikadoFamily InformationFamily Last Name* Address* Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address* Phone Number*Head of HouseholdName* First Last Maiden (If Applicable) Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender* Male Female Email* Cell Phone*Religion* Sacraments Received* Baptism Eucharist Reconciliation Confirmation None Marital Status* Single Married Divorced Widowed Do you have dependent children?* Yes No Spouse InformationName* First Last Maiden (If Applicable) Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender* Male Female Email* Cell Phone*Religion* Sacraments Received* Baptism Eucharist Reconciliation Confirmation None Baptism Info Children InformationChildren Information*Please click the ‘+’ to add another child’s informationNameGenderBirthdateSchool Additional Children Information*Please click the ‘+’ to add another child’s information, please keep in same order as above.NameReligionSacraments Received Additional InformationAny Additional Information you'd like us to know?Do you want an email copy sent to you?* Yes No PhoneThis field is for validation purposes and should be left unchanged.
