PARISH REGISTRATION FORM

Date:
Last Name:
Address:
City:			Zip:
E-mail Address:			Subdivision:
Primary Phone: Head of House Work Phone: Head of House Cell Phone Spouse Work Phone: Spouse Cell Phone

FAMILY INFORMATION
*Required for each person living in your household, this information is used to maintain the Diocesan Census.
Marital Status / M=Married; S=Single; Se=Separated; D=Divorced; W=Widow(er); N/A for children under 18
For Non-Catholic Members baptized and/or confirmed in another faith, please list denomination (optional).
To be certain the Diocese is serving the needs of all its people, you are asked to include race (optional).

*First Name Middle Initial	*Gender (M/F)	"Goes By" Name	*Marital Status	Catholic Y or N Baptized - B *Confirmed - C	*DOB Incl. Year	Race

Last Parish Attended: City State
Emergency contact person not residing in your household:
Phone:

How may we serve You?
I/We would like to register in St. Mark Parish.
I am interested in the program for returning Catholics.
I am interested in finding out about the Catholic Faith.
I am interested in becoming Catholic.
I would like to have a Priest contact me.

To ensure that active participation is known to the parish, I/We prefer the offertory method checked below:

AUTO BANK Debit Personal Checks

One time Annual Gift Church Envelopes

I would like more information about:

LITURGICAL MINISTRIES	FAITH FORMATION
ADULT CHOIR ALTAR CARE ALTAR SERVER ALTAR SERVER-HISPANIC ANOINTING MASS VOLUNTEER CHILDREN'S CHOIR EXTRAORDINARY MINISTERS GREETER AT MASS LECTOR LITURGY COMMITTEE MUSIC-SPANISH MASS SACRISTAN USHER	EUCHARIST ADORATION ADULT BIBLE STUDY BAPTISM PREPARATION CATECHESIS OF THE GOOD SHEPHERD CATECHESIS HISPANICS CHARISMATIC PRAYER FAITH FORMATION YOUTH GENERATION OF FAITH LITTLE LAMBS SUNDAY MARRIAGE PREPARATION MOTHERS PRAYER & STUDY GROUP PARISH LIBRARY TORCH-CATH. HOMESCHOOL YOUTH MINISTRY
OUTREACH	FAMILY LIFE
BREAD OF LIFE ...GLEANING CATHOLIC CHARITIES GOOD SHEPHERD MINISTRIES HABITAT FOR HUMANITY JAIL/PRISON MINISTRY MEALS ON WHEELS RESPECT LIFE SOCIAL OUTREACH TILESTON OUTREACH VINTAGE VALUES SOCIAL OUTREACH COMMITTEE	BOY SCOUTS COMFORT COMMITTEE CUB SCOUTS SENIORS IN MOTION
EVANGELIZATION	ST. MARK CATHOLIC SCHOOL
CAMILLUS-SICK AND SHUT-INS COME HOME EVANGELIZATION COMMITTEE HISPANIC MINISTRY RCIA- SPONSORS STEWARDSHIP COMMITTEE	GENERAL NEEDS VOLUNTEERS INDIVIDUAL TUTOR LUNCH MONITOR TECHNOLOGY
OTHER MINISTRIES	PARISH FACILITIES/PROGRMS
ANCIENT ORDER OF HIBERNIANS BAPTISMAL STOLE MINISTRY BLANKET MINISTRY LADIES ANCIENT ORDER OF HIBENIANS PARISH PICNIC COMMITTEE PRAYER SHAWL MINISTRY ROSARY MAKERS SOCIAL EVENTS COMMITTEE SUNDAY COFFEE & DONUTS	ADMINISTRATION SUPPORT BUILDINGS AND GROUNDS COMMUNICATIONS TEMPORALITIES

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Office use only:
Envelope #____________________________Welcome Committee_____________________________________
Entered/Parish Records__________________Reported To Diocese______________________________________

St. Mark Catholic Church | 1011 Eastwood Rd. Wilmington, NC 28403

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