‐ HOLY NAME CATHOLIC CHURCH Office Use Only 920 11th St., Washington, DC 20002-3702 Envelope Number ARCHDIOCESE OF WASHINGTON Parish Registration Form (Please Print or Circle Response)
New Household or Update/Correction
Mailing Name______(Example Mr. & Mrs. Smith
Mailing Address______
Home Address (if different from mailing address):
______
Email address: ______(Important parish information is sent via email)
Is Home: Own/Rent How long have you been at this address? ______
Parishioner: Present religion: Catholic
______(First Name) (Middle) (Maiden Name if applicable) (First Name) (Middle) (Maiden Name if Applicable) Sex: M/F Title: Mr./Mrs/Ms/ Miss/Dr/ Other: ______Sex: M/F Mr/Mrs/Ms/Miss/Dr/Other ______Date of Birth______Place: (Date of Birth) (Place: City/State) City/State______Relationship: Husband/Wife/Other: ______Relationship: Husband/Wife/Other ______Education: High School/College/Masters/Other:______Education: High School/College/Master/Other Ethnicity: Af Am/Caucasian/Hispanic/Asian./Other: ______Initiation Rites: Ethnicity: Af Am/Caucasian/Hispanic/Asian./Other :______Have you received the initiation rites of the Church? Yes/No ______Employment (Business Phone) If no, what sacrament(s) do you need? ______Occupation ( Email Address) Baptism/Reconciliation/Communion/Confirmation
Initiation Rites:
Have you received the initiation rites of the Church? Yes/No
If no, what sacrament(s) do you need?
Baptism/Reconciliation/Communion/Confirmation
Marital Status:
Single/Marries/Widowed/Separated/Divorced
If married, were you married in the Catholic Church? Yes/No
Contributions:
Do you use offertory envelopes? Yes/No
If no, do you want them? Yes/No
Spouse: Present Religion: ______
______
CHILDREN: (Birth through High School) Enter last name if different from Head of Household Check if received Name: First Middle Last M/F Birth Date Birthplace (City, State) Baptism Communion Confirmation
Older Grown Children (Living at home) Check if received: Name: First Middle Last M/F Birth Date Birthplace (City, State) Baptism Communion Confirmation
OTHER ADULTS: (Living at home) Name First/Middle/Last M/F Birth Date Relationship to Head of Household Occupation
Parish Activities
(Please check if interested)
Building & Maintenance Youth Ministry ( )
Maintenance Work ( ) Social Concerns
Liturgy St. Vincent De Paul Society ( )
Altar Servicers ( ) Other:______Extraordinary Ministers ( ) ______Ministry to the Sick & Homebound ( ) ______
Lectors ( ) Comments:______Ushers ( ) ______Parish Choir (11:00 AM Mass ( ) ______Sacristan ( )
Parish Life Our Mission..... Ladies of Charity ( ) We the Roman Catholic Church of the Holy Name of Jesus, Sodality ( ) are Christ's ambassadors of hospitality in the nation's capital. Knights of Columbus ( ) Established as a parish on 1891, we are committed to Knights of St. John ( ) proclaim the Good News of Jesus Christ, to share our faith with everyone and to follow the example of Mary. We strive Junior Auxiliary #4 ( ) to be spiritually, socially and culturally focused, and we open Bereavement Ministry ( ) our hearts and doors to all God's children. We offer a faith Education & Youth Ministry filled and love-filled environment. PSR Religious Education ( )