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Register as a Parishioner

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  I am a.... New Parishioner Current Parishioner Undergrad student Graduate student None of the Above
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Does your family have any special needs with which we can help? Please enter the names of any members to whom this applies in the space provided.
  
  Homebound Please enter valid data.
  
  Nursing Home Resident Please enter valid data.
  
  Physically Disabled Please enter valid data.
  
  Visually Impaired Please enter valid data.
  
  Hearing Impaired Please enter valid data.
  
  Other: Please enter valid data.
  
  Head of Household REQUIRED Please fill out this field.
  
  Head of Household 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Head of Household 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Head of Household 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Head of Household 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Marital Status REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Additional Family Member REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  GET CONNECTED -- STAY INVOLVED!
  The time and talent of every member of our parish are important to us. Please check mark the ministries your family will stay involved in so we can keep our records current, and tell us which ones you'd like to know more about!
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  GET CONNECTED -- STAY INVOLVED!
  The time and talent of every member of our parish are important to us. Please check mark the ministries your family will stay involved in so we can keep our records current, and tell us which ones you'd like to know more about!
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  GET CONNECTED -- STAY INVOLVED!
  The time and talent of every member of our parish are important to us. Please check mark the ministries your family will stay involved in so we can keep our records current, and tell us which ones you'd like to know more about!
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  GET CONNECTED -- STAY INVOLVED!
  The time and talent of every member of our parish are important to us. Please check mark the ministries your family will stay involved in so we can keep our records current, and tell us which ones you'd like to know more about!
  
  Do you have ideas for parish ministries & events? Share them with us! Reach out to any clergy or staff member and let us know what you'd like to make happen at St. Austin! Thank you for your discipleship!
  
  Submit
  
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