New Parishioner Registration

Date REQUIRED Please fill out this field. Please enter a date.

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Head of Household REQUIRED Please fill out this field. Please enter valid data.

Sex REQUIRED Please fill out this field.

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.

Home Phone REQUIRED Please fill out this field. Please enter valid data.

Cell Phone Please enter valid data.

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

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Martial Status REQUIRED Please fill out this field.

Occupation REQUIRED Please fill out this field. Please enter valid data.

Race or Ethnic Group

Religion REQUIRED Please fill out this field.

Sacraments REQUIRED

Check all sacraments received.

Baptism Reconcilation First Eucharist Confirmation Please fill out this field.

Spouse's Name Please enter valid data.

Spouse's Last Name if different than Head of Houshold Please enter valid data.

Spouse's Cell Phone Please enter valid data.

Spouse's Email Please enter an email address.

Spouse's Date of Birth Please enter valid data.

Sex

Spouse's Occupation Please enter valid data.

Spouse's Religion

Sacraments

Check all sacraments received.

Baptism Reconcilation First Eucharist Confirmation None

Do any members of your household have any physical challenges that would require accommodation in order to attend Mass or other Church events?

Does anyone in your household have special needs that we can assist you with?

Are there any ministries you have a particular interest in receiving services from or are there ministries you would be interested in volunteering for?

Do you have any talents you wish to share with the Faith Community of St. John the Evangelist?

Saint John the Evangelist
Catholic Church and School

Streamwood, IL

New Parishioner Registration