Parish Registration Form
The information requested on this form includes all the data that is listed in our parish records. Names and contact information are necessary. All other information may be supplied or withheld at your discretion.

CONTACT INFORMATION

Family Name:

Street Address:

Mailing Address:

City:     State:     Zip:
Phone Number:

Email Address:

MISC. INFORMATION

Language Spoken at Home:

Family Residence:
    Mass Attendance:
Marriage Status:

(If Married)
by whom:     Date of Marriage:
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List Only Those Living With You Below

HUSBAND INFORMATION

Full Name

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)

WIFE INFORMATION

Full Name (w/ maiden)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)
Add More People

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)
Add More People

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)
Add More People

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)
Add More People

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)

ADDITIONAL INFORMATION

Full Name (w/ relation)

Date of Birth

Country of Birth

Religion

Completed Sacraments
Baptism:

First Communion:

Confirmation:
Other Info (Education/Occupation/Phone)


Enter following code into box to verify submission: C K O X N   



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St. Bridget Church:
12 Church Street, West Rutland, VT 05777 +Map
St. Stanislaus Kostka Church:
11 Barnes Street, West Rutland, VT 05777 +Map
St. Dominic Church:
45 South St, Proctor, VT 05765 +Map