Parish Registration Form

Fill out the form here or you can also contact the parish office by phone at

(901) 353-1530 or by email and we will be happy to help you fill out a registration form.

Your Name:

First Name *

Last Name *

Occupation

Employer

Spouse's Name (If Applicable)

First Name

Last Name

Occupation

Employer

Family Info

Marital Status *

# of Family Members

Names of Children:

Mailing Address

Mailing Name:

Address

City

State

Zip Code

Communications

Home Phone

Family Email:

Cell Phone (Husband)

Cell Phone (Wife)

Emergency Contact

Name:

Phone #:

Primary Language

Talents / Interests

Volunteer Availbility

Do you or does a member of your family have a disability about which you wish the parish to know?

Are there any ill or disabled memebers of your household who would like a Holy Communion visit by a Priest?

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For more information about how you can become involved in the ministries and activities of our parish, please visit the other pages of this website.