Parent/Guardian Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone *

(###)

###

####

Our family has a stewardship pledge on file with the parish this year *

Yes

No

Student 1 *

First Name

Last Name

Student 2

First Name

Last Name

We attend church *

Regularly

Frequently

Infrequently

Never

Would you like more information on volunteering at the parish? *

Yes

No

Contributions are made to the parish *

Weekly

Monthly

Other

Method of Contribution *

Envelope

Check

Cash

Electronic

Signature *

I understand that checking this box and providing my name below constitutes a legal signature