Flocknote Facebook Email Instagram Phone

Resident Parishioner Registration

- I'm New

The maximum number of form submissions has been reached. This form is currently not available.
- Welcome to St. Francis of Assisi!
  
  To register as a Resident Parishioner and/or a family, please fill out the form below.
  
  (Please know that your information will not be shared with any 3rd parties and is for the parish office use only)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address/Apt # REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Employer REQUIRED Please fill out this field. Please enter valid data.
- Occupation REQUIRED Please fill out this field. Please enter valid data.
- Work Phone REQUIRED Please fill out this field. Please enter valid data.
- Email Address REQUIRED Please fill out this field. Please enter an email address.
- Preferred Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Secondary Phone Number Please enter valid data.
- Marital Status REQUIRED Single Married Divorced Separated Widowed Please fill out this field.
- Spouse Information
  
  Marriage Date Please enter a date.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Preferred Phone Number Please enter valid data.
  
  Spouse Date of Birth Please enter a date.
  
  Spouse Religion Please enter valid data.
  
  Spouse Employer Please enter valid data.
  
  Spouse Occupation Please enter valid data.
  
  Spouse Work Phone Please enter valid data.
- Number of Dependants REQUIRED Please fill out this field.
  
  Dependant 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
  
  Dependant 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date/Year of Baptism Please enter valid data.
  
  Date/Year of First Communion Please enter valid data.
  
  Date/Year of Confirmation Please enter valid data.
- Other
  
  Consent to Use Image(s) and Name(s) REQUIRED
  I/we hereby give permission to St. Francis of Assisi University Parish and Newman Center to us my/our likeness and my/our name(s) in all forms and media for reporting parish activities or in advertising for any other lawful purpose.
  Please fill out this field.
Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

St. Francis of Assisi Parish & Newman Center

Muncie, in

Resident Parishioner Registration