New Parishioner Registration

Family Name Please enter valid data.

Street 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.

Mailing Address if Different Please enter valid data.

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

Preferred Family Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Language Spoken in the home Please enter valid data.

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

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

Email Please enter valid data.

Mobile Phone Please enter valid data.

Occupation Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Life Status REQUIRED Please fill out this field.

Religion REQUIRED Please fill out this field.

Check the Sacraments Received Baptism Eucharist Confirmation

Role in Household REQUIRED Wife Husband Self Child Stepparent Parent Grandparent Please fill out this field.

Spouse, if applicable Please enter valid data.

Date of Birth Please enter valid data.

Email Please enter valid data.

Mobile Phone Please enter valid data.

Gender Male Female

Occupation Please enter valid data.

Religion Catholic Protestant Jewish Other

Life Status Single Married Divorced Widowed

Check the Sacraments Received Baptism Eucharist Confirmation

Role in Household Wife Husband Self Child Stepparent Parent Grandparent

Number of Additional Family Members REQUIRED Please fill out this field.
Family Member 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.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 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.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 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.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 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.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 7
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other
Family Member 8
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Email Please enter an email address.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Occupation if applies Please enter valid data.
- Life Status REQUIRED Single Married Divorced Widowed Please fill out this field.
- Check Sacraments Recieved REQUIRED Baptism Eucharist Confirmation None of the Above Please fill out this field.
- Religion REQUIRED Catholic Protestant Jewish Other Please fill out this field.
- Role in Household Child Step Parent Grandparent Other

St. Vincent Martyr

A Roman Catholic Presence in Madison Since 1805

New Parishioner Registration

Print a new Parishioner Form