Over Half a Century

of Faith and Service

Plymouth, MI

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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 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:
  
  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:
  
  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:
  
  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:
  
  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:
  
  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:
  
  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:
  
  Nickname: Please enter valid data.
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Over Half a Century

of Faith and Service

Plymouth, MI

Join Our Parish!

Saint Kenneth Parish Registration Form

Saint Kenneth Catholic Community

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