New Parishioner Registration Form "*" indicates required fields The BasicsYour Name* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Middle Last Suffix Your Preferred Name* Your Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Your Mailing Address* Street Address Apartment/Unit Number (if applicable) City State/ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Mobile Phone Number*Your Email Address* Getting to Know YouAre you Catholic?* Yes No Would you like us to contact you about becoming Catholic?You can also visit https://cathedralctk.com/rcia to learn more. Yes, please No, thanks FamilyWhich describes you?* Single Married Divorced Widowed Your Spouse's Name* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Middle Last Suffix Your Spouse's Preferred Name* Your Spouse's Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Your Spouse's Phone Number(s)* Add RemoveYour Spouse's Email Address* Is your spouse Catholic?* Yes No Would you like us to contact you about becoming Catholic?You can also visit https://cathedralctk.com/rcia to learn more. Yes, please No, thanks ChildrenHiddenDo you have children?* Yes No HiddenTell us about your children!*Click the (+) button on the right to add additional children. NameDate of BirthGender Add RemoveHow many children under the age of 18 live in your home?*0123456+Your First ChildYour First Child's Name* First Last Your First Child's Date of Birth* Month Day Year Your First Child's Gender* Male Female Which sacraments has your first child received? Baptism First Reconciliation First Communion Confirmation Estimated Date of First Child's Baptism Month Day Year Estimated Date of First Child's First Reconciliation Month Day Year Estimated Date of First Child's First Communion Month Day Year Estimated Date of First Child's Confirmation Month Day Year Your Second ChildYour Second Child's Name* First Last Your Second Child's Date of Birth* Month Day Year Your Second Child's Gender* Male Female Which sacraments has your second child received? Baptism First Reconciliation First Communion Confirmation Estimated Date of Second Child's Baptism Month Day Year Estimated Date of Second Child's First Reconciliation Month Day Year Estimated Date of Second Child's First Communion Month Day Year Estimated Date of Second Child's Confirmation Month Day Year Your Third ChildYour Third Child's Name* First Last Your Third Child's Date of Birth* Month Day Year Your Third Child's Gender* Male Female Which sacraments has your third child received? Baptism First Reconciliation First Communion Confirmation Estimated Date of Third Child's Baptism Month Day Year Estimated Date of Third Child's First Reconciliation Month Day Year Estimated Date of Third Child's First Communion Month Day Year Estimated Date of Third Child's Confirmation Month Day Year Your Fourth ChildYour Fourth Child's Name* First Last Your Fourth Child's Date of Birth* Month Day Year Your Fourth Child's Gender* Male Female Which sacraments has your fourth child received? Baptism First Reconciliation First Communion Confirmation Estimated Date of Fourth Child's Baptism Month Day Year Estimated Date of Fourth Child's First Reconciliation Month Day Year Estimated Date of Fourth Child's First Communion Month Day Year Estimated Date of Fourth Child's Confirmation Month Day Year Your Fifth ChildYour Fifth Child's Name* First Last Your Fifth Child's Date of Birth* Month Day Year Your Fifth Child's Gender* Male Female Which sacraments has your fifth child received? Baptism First Reconciliation First Communion Confirmation Estimated Date of Fifth Child's Baptism Month Day Year Estimated Date of Fifth Child's First Reconciliation Month Day Year Estimated Date of Fifth Child's First Communion Month Day Year Estimated Date of Fifth Child's Confirmation Month Day Year Additional ChildrenPlease provide information about additional children here. A Few Last ThingsWould you like to receive a free subscription to the Georgia Bulletin, the Archdiocese of Atlanta's official newspaper?* Yes, please No, thank you Do you prefer online giving, or would you prefer to receive free envelopes for the offertory at Mass?*Set up your online giving at cathedralctk.com/give. Online giving Offertory envelopes
