St. Stephen Catholic Church, 506 W Union St, PO Box 379, Lake City, MI 49651
Diocese of Gaylord Parish Registration Form
This form can be used to: Register as a new parishioner or parish family, or to update existing parishioner data. All information is for internal parish use only. Please print a copy to fill out and return to the office or with offertory.
PLEASE PRINT Date:
| St. Stephen Catholic Church Mailing Address: PO Box 379, Lake City, MI 49651506 Union St., Lake City, MI 49651Phone: 231-839-2121 ~ Fax: 231-839-3755 Email: ststephenlakecity@gmail.com | Envelopes: (Please check one)Please mail them_______I will pick them up in the office_______I will pick them up from the box in the church entry__x__ |
| Family Info: | Head of Household:Last Name: ____________________________________First Name: ________________Middle: _____________Title: ________ Nick-name________________________Maiden Name: _________________________________Religion: ___________________________________Gender: □ Male □ Female Birthdate: ____________________________________Occupation: ___________________________________Employer: ___________________________________Status: □ Single □ Married □ Widowed □ Divorced □ Religious □ Other __________________________Sacraments:Baptism: Yes No Church: _____________________________________ City/State: ___________________________________1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes NoMarried on: ___________________________________ Church: ____________________________________ City/State: ___________________________________Were you married in the Catholic Church? Yes NoWere you previously married? Yes No Has this marriage been annulled? Yes No | Spouse:Last Name: _____________________________________First Name: ________________Middle: ______________Title: ________ Nick-Name_________________________Maiden Name: ___________________________________Religion: _____________________________________Gender: □ Male □ Female Birthdate: ____________________________________Occupation: ____________________________________Employer: ____________________________________Status: □ Single □ Married □ Widowed □ Divorced □ Religious □ Other __________________________Sacraments:Baptism: Yes No Church: _______________________________________ City/State: _____________________________________1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes NoWere you previously married? Yes No Has this marriage been annulled? Yes No | |
| : | Did you attend St. Stephen in childhood? Yes NoGraduation Year _________Maiden Name if different _______________________ | Did you attend St. Stephen in childhood? Yes NoGraduation Year _________Maiden Name if different _______________________ | |
| Phones:Email: | Home: ________________________________________Cell: _________________________________________Work: _________________________________________Family Email: __________________________________Personal Email: _________________________________ | Cell: ___________________________________________Work: ___________________________________________Personal Email: ___________________________________ | |
| MailingAddress: | Mailing Address: ________________________________City/State/Zip: __________________________________ Home Address: _________________________________City/State/Zip: __________________________________(if different from mailing address) | SeasonalAddress: | Send mail to this address:From: Month __________ Day __________To: Month __________ Day __________Address: ___________________________________City/State/Zip: _______________________________Phone: _____________________________________ |
Please list all children that are living in the home from oldest to the youngest. If Child is 18 or older, they should fill out their own registration form. If you have more than 4 children, please list them on another form and attach it to this sheet.
| Child #1Last Name: ________________________________________________First Name: _________________________Middle: ________________Nickname: _________________________________________________Birthdate: _________________________________________________Religion: _________________________________________________Handicap: _________________________________________________Grade: ________________________________________________School Attending: ___________________________________________Gender: □ Male □ Female | Sacraments:Baptism: Yes No Church: _____________________________________ City/State: ___________________________________ 1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes No |
| Child #2Last Name: ________________________________________________First Name: _________________________Middle: ________________Nickname: _________________________________________________Birthdate: _________________________________________________Religion: _________________________________________________Handicap: _________________________________________________Grade: ________________________________________________School Attending: ___________________________________________Gender: □ Male □ Female | Sacraments:Baptism: Yes No Church: _____________________________________ City/State: ___________________________________ 1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes No |
| Child #3Last Name: ________________________________________________First Name: _________________________Middle: ________________Nickname: _________________________________________________Birthdate: _________________________________________________Religion: _________________________________________________Handicap: _________________________________________________Grade: ________________________________________________School Attending: ___________________________________________Gender: □ Male □ Female | Sacraments:Baptism: Yes No Church: _____________________________________ City/State: ___________________________________ 1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes No |
| Child #4Last Name: ________________________________________________First Name: _________________________Middle: ________________Nickname: _________________________________________________Birthdate: _________________________________________________Religion: _________________________________________________Handicap: _________________________________________________Grade: ________________________________________________School Attending: ___________________________________________Gender: □ Male □ Female | Sacraments:Baptism: Yes No Church: _____________________________________ City/State: ___________________________________ 1st Penance: Yes No 1st Communion: Yes NoConfirmation: Yes No |
| OFFICE USE ONLY: |
St. Stephen Catholic Church 