St. Bernardine Roman Catholic Church

Registration/Census Form

(Online)

Please provide us with the following information. Thank you for your assistance.

Please select one *
Date *
Date
Household Address *
Household Address
Home Phone
Home Phone
List SEPARATELY each person living in your household. Please list yourself first
Full Name *
Full Name
Include your middle name or initial.
Birth Date *
Birth Date
Cell Phone
Cell Phone
Work Phone
Work Phone
Full Name
Full Name
Date of Birth
Date of Birth
Cell Phone
Cell Phone
FullName
FullName
Please include middle initial or name
Birth Date
Birth Date
Cellphone:
Cellphone: