St. Theresa the Little Flower/ Parishioner Registration Form

843-875-5002 or 875-6911

Date Registered: ______

Family Email address______

Last Name: ______Mr. & Mrs.; Mr. Mrs. Miss Ms. Dr.(Circle one)

Address: ______Subdivision: ______

City: ______Zip Code: ______Home Phone: ______

Husband’s Cell #______Husband’s Email______

Wife’s Cell#______Wife’s Email:______

Maiden Name:______

Marital Status (Circle one): Catholic Church Married; Married; Single; Divorced; Separated; Widow

Please No Nicknames / Head of Household / Spouse / Child / Child / Child / Child
First Name
Gender
Birthdate
Language
Ethnicity
Religion
Handicap
Occupation
Place of
Employment

Baptism

First Penance

First Communion

Confirmation

CHECK SACRAMENTS THAT EACH MEMBER HAS RECEIVED.

Please turn over

The Catholic Miscellany is the State Diocesan Newspaper.

Would you like to receive a subscription? Yes No ($19.00 billed annually to the parish).

Are you homebound and would like a Eucharistic Minister to visit you? Yes No

There are opportunities for you to become involved at St. Theresa, would you like to be contacted?

Add the first name of the person next to the opportunities of your choice.

Please tell us your Mass preference when volunteering______

ACTIVE PARISHIONERS: are those who participate in the ministries, organizations and services of

St. Theresa Parish and they equitably share in the financial support of the community. Recently, people have been disappointed when they asked us for verification of their parishioner status for purposes of marriage, baptism, Catholic School registration or sponsorship. Your name on the rolls is not enough. Please use your envelopes each and every time that you attend Mass. It is the only way that we can track attendance and VERIFIES your status as an active parishioner.

Signature please______I have read the above statement.

Revised 11/15