Parish Registration

Welcome to Assumption of the Blessed Virgin Mary! To register as a parishioner, please:

fill out the form below.

Required *

Family Last Name *

Address *

City *

State *

Zip *

Telephone: Home *

Telephone: Work

Telephone: Cell

Head of Household (name: first/middle/last) *

Date of Birth

Spouse (name: first/middle/last)

Date of Birth

Children/Dependents (Adult children living at home should register themselves)

Name

Date of Birth

Status (at home/in college)

Name

Date of Birth

Status (at home/in college)

Name

Date of Birth

Status (at home/in college)

Time/Talent/Treasure: Please list talents & skills

Would you or anyone in your household like additional information about parish ministries or volunteer programs?

Parish Financial Support Options

Please let us know how you would like to support our parish (weekly envelopes/other) *

Do you or someone in your family have a special need that hinders full participation at Mass (ie. hearing/sight impaired, disability, shut-in, etc)?

If so, how may the parish minister to you/their needs (ie. bring Communion, home visits, prayer lists, etc.)?

Name of individual(s) who would like assistance:

Do you have other family or non-family members living in your household? yes&nbsp &nbsp

If yes, please list their names, relationship (grandparent/niece/aunt/etc.), along with their religion:

Church of The Assumption of The Blessed Virgin Mary