Parent Registration Form

Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Religion REQUIRED Please fill out this field. Please enter valid data.

Mother's Email REQUIRED Please fill out this field. Please enter an email address.

Mother's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Father's Full Name REQUIRED Please fill out this field. Please enter valid data.

Father's Religion REQUIRED Please fill out this field. Please enter valid data.

Father's Email REQUIRED Please fill out this field. Please enter an email address.

Father's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Street 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.

Are you married in the Catholic Church? REQUIRED Yes No Please fill out this field.

If not, would you like more information on Marriage in the Catholic Church? REQUIRED Yes No Please fill out this field.

Are you a registered parishioner at St. Mark? REQUIRED Yes No Please fill out this field.

If not, where are you registered? (Please provide name, city, and state of church) Please enter valid data.

When did you complete the Baptism Preparation Course? Please enter valid data.

Child's Name, if born Please enter valid data.

Child's Birthdate or Due Date Please enter a date.

City and State of Child's Birth Please enter valid data.

Was Child Adopted? Yes No

Was child baptized before? Yes No

Godmother's Full Name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Religion REQUIRED Please fill out this field. Please enter valid data.

Godfather's Full Name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Religion REQUIRED Please fill out this field. Please enter valid data.

Language Preference REQUIRED English Spanish Please fill out this field.

St. Mark the Evangelist Catholic Church