St Alphonsus Parish 
Parishioner Information Form

Please take a moment to fill out our Parish Information Form, Please make every effort to fill it out completely.

First, please tell us if you are a new parishioner or updating your parish file.

I am new parishioner.
I am updating my parish file.

Adult 1:                                                              * are required

*First Name
Middle Initial
*Last Name
Date of Birth	(dd/mm/yyyy)
Religion
Occupation
Street Address
Address (cont.)
City
Province
Postal Code	(Like: K9J6X2)
Country
*Home Phone
Work Phone
FAX
E-mail
Marital Status	Single Married Common Law Widow(er)
Date of Marriage	(dd/mm/yyyy)

Adult 2:

First Name
Middle Initial
Last Name
Date of Birth	(dd/mm/yyyy)
Religion
Occupation
Street Address
Address (cont.)
City
Province	(Like: ON)
Postal Code	(Like: K9J6X2)
Country
Home Phone
Work Phone
FAX
E-mail

Are you a Separate School Supporter?

YES      NO        If not, would you like to be?        YES      NO

Which ministry or parish organization would you like to help out with?

Altar Serving Banner Committee C.W.L. Children's Liturgy Communion to the hospital Communion to the housebound Computer Ministry Cursillo Movement Development and Peace Eucharistic Minister at Sunday Liturgy Family Mass Knights of Columbus Liturgy Committee Marriage Encounter Ministers of Hospitality (Ushers) Ministers of the Word Music Ministry Parents and Tots Group R.C.I.A. St. Vincent de Paul

For children Living at Home, please provide the following information:
(Note: Once you have filled in the information for your children, please scroll down. There are some more questions as well as the Form Submit button below.) 

Child 1:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Child 2:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Child 3:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Child 4:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Child 5:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Child 6:

First Name
Middle Initial
Last Name
Gender	Male Female
Date of Birth	(dd/mm/yyyy)
Baptized date	(dd/mm/yyyy)
1 St Communion Date	(dd/mm/yyyy)
Confirmed Date	(dd/mm/yyyy)
School or Company Name

Is there someone in your home unable to celebrate regular Sunday Eucharist?

YES      NO

If so please enter their name:

Would you like to bring Communion home to them?

YES      NO

OR would you like a parish visitor to bring communion regularly to them?

YES      NO

Are you an envelope user?

YES      NO      If YES, please enter your envelope number: 

Would you be willing to use envelopes (for income tax purposes?)

YES      NO

YES      NO