Old Mission San Juan Bautista Parish Registration Form

  • LAST Name
  • Home Telephone Number
  • Name for Addressing Mailings
    (e.g., Mr. & Mrs. John Smith OR John and Jane Smith)
  • Address
  • Full Name
    Head of Household
  • Date of Birth
  • Religion
  • Baptized
  • Email Address
  • Cell Phone
  • Interests
    (eg., Lector, Eucharistic Minister, Volunteer, Cantor, etc.)
  • Name of Spouse
  • Date of Birth
  • Religion
  • Baptized
  • Gender
  • Cell Phone
  • Email Address
  • Interests
    (Lector, Eucharistic Minister, Volunteer, Cantor, etc)
  • Name of Child / Other Adult
  • Date of Birth
  • Religion
  • Baptized
  • Gender
  • Name of Additional Child / Other Adult
  • Date of Birth
  • Religion
  • Baptized
  • Gender
  • Name of Additional Child / Other Adult
  • Birthdate
  • Religion
  • Baptized
  • Gender
  • Name of Additional Child / Other Adult
  • Birthdate
  • Religion
  • Baptized
  • Gender
  • I would like to receive
  • Comments
  • Security Code*

     

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