• Saint Kenneth Parish Registration Form
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  • Family Information
    • Family Name (Last Name Only) 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 AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

      Zip REQUIRED Please fill out this field. Please enter a zip code.
    • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
    • Email REQUIRED Please fill out this field. Please enter an email address.
    • Do you want to be listed in the Parish Directory? Yes No
  • Male Head of Household
    • First Name Please enter valid data.
    • Middle Name Please enter valid data.
    • Last Name Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Cell Phone Number Please enter a phone number.
    • Catholic? Yes No
    • If No, what religion? Please enter valid data.
    • Baptized? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Marital Status Single Married Widowed Divorced
    • Marriage Date (if applicable) Please enter valid data.
    • Catholic Marriage? (if applicable) Yes No
    • Employer Please enter valid data.
    • Occupation Please enter valid data.
    • Work Phone Number Please enter a phone number.
    • Nickname (to be used in letters, parish directory, etc.) Please enter valid data.
    • Number of Children Living at Home Please enter valid data.
  • Female Head of Household
    • Preferred Honorific Ms. Miss Mrs.
    • First Name Please enter valid data.
    • Middle Name Please enter valid data.
    • Last Name (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Cell Phone Number Please enter a phone number.
    • Email Please enter an email address.
    • Catholic? Yes No
    • If No, what religion? Please enter valid data.
    • Baptized? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Marital Status Single Married Widower Divorced
    • Maiden Name Please enter valid data.
    • Catholic Marriage? (if applicable) Yes No
    • Employer Please enter valid data.
    • Occupation Please enter valid data.
    • Work Phone Number Please enter a phone number.
    • Nickname (to be used in letters, parish directory, etc.) Please enter valid data.
  • Dependent 1
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 2
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 3
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 4
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 5
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 6
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.
  • Dependent 7
    • Name - First, Middle, Last (if different) Please enter valid data.
    • Birthdate (mm/dd/yyyy) Please enter valid data.
    • Please check one: Female Male
    • Baptized Catholic? Yes No
    • First Communion? Yes No
    • Confirmed? Yes No
    • Completed years of religious education: Please enter valid data.
    • School Name: Please enter valid data.
    • Grade: None Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Graduated
    • Nickname: Please enter valid data.

  Submit

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