St. Mary's Navilleton Parish New Parishioner Registration

Please fill out this form online, print it out, and bring or mail it to St. Mary's Navilleton Church, 7500 Navilleton Rd. Floyds Knobs, IN 47119.  Please print page 2 on the reverse of page 1.

For office use only:  envelope #____________

Family Last Name
First               Spouse
How would you like your mail to be addressed?  Mr./Mrs.   Mr.   Mrs.   Miss   Other 

Street Address
Mailing Address (if different)
City        State          Zip   

Home Phone    Listed   Unlisted         E-mail Address

If you would like to participate in any parish ministries, please specify which ministry

Marital Status   Church married     Married     Single     Divorced     Separated     Widowed
Date and church of marriage

  Self Spouse Child Child
First name
Last/maiden name or nick name
Religion
Occupation
Education
Gender
Date of birth
Baptism yes    no yes    no yes    no yes    no
Reconciliation yes    no yes    no yes    no yes    no
1st Communion yes    no yes    no yes    no yes    no
Confirmation yes   no yes    no yes    no yes    no
List special needs if any

 

 

 

  Child Child Child Child
First name
Last/maiden name or nick name
Religion
Occupation
Education
Gender
Date of birth
Baptism yes    no yes    no yes    no yes    no
Reconciliation yes    no yes    no yes    no yes    no
1st Communion yes    no yes    no yes    no yes    no
Confirmation yes    no yes    no yes    no yes    no
List special needs if any