Complete this form to register as a new parishioner of Our Lady of the Assumption Parish. Fields marked with an asterisk are required.

* Required

Family Name *

Street Address *

Apt. #

City *

Postal Code *

Phone Number *

Email Address *

Primary Member

Salutation *

First Name *

Birthday *

Occupation *

Cell Phone *

Email Address *

Status *

Marriage Date:

Spouse

Salutation:

First Name:

Birthday:

Cell Phone:

Email Address:

Children

If applicable, complete the details for up to four children.

Child 1

First Name:

Last Name:

Birthday:

School or Occupation:

Child 2

First Name:

Last Name:

Birthday:

School or Occupation:

Child 3

First Name:

Last Name:

Birthday:

School or Occupation:

Child 4

First Name:

Last Name:

Birthday:

School or Occupation:

Additional Information

Do you wish to begin using offertory envelopes? *

Submit This Form

When you are satisfied with the information you’ve provided, press “Submit” below.