Parish Registration Form

Welcome to the on-line registration form for Little Flower Catholic Church. We are happy you have decided to make Little Flower your Parish Home!
When you submit this form, all of the information will be sent by e-mail to Little Flower.

Head of Household

• Title Mr. Mrs. Dr. Ms.	First Name*	Last Name*	Suffix Sr. Jr. |||
  Maiden Name

• Birth Date*

  Gender* Female Male

Address

• Phone*
• Line 1*
• Line 2
• City *
• State *
• ZIP*
• Email*

Phone

• Primary*

  Home Cell Work

• Other

  Home Cell Work

Marital Status

• Married by Priest
• Married(other)
• Never Married
• Widowed
• Divorced
• Separated

Sacraments

• Sacraments	Received(Y/N)	Date
  Baptism
  First Reconciliation
  First Communion
  Confirmation
  Marriage

Other

• Occupation
• Place of Employment
• Religion
• Languages Spoken

[+Add Family Member]   [+Add Spouse]

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Member -

• Member Type Son Daughter Wife Husband

• Title Mr. Mrs. Dr. Ms.	First Name*	Last Name*	Suffix Sr. Jr. |||
  Maiden Name

• Birth Date*

  Gender* Female Male

Sacraments

• Sacraments	Received(Y/N)	Date
  Baptism
  First Reconciliation
  First Communion
  Confirmation
  Marriage