Parish Membership Registration

Please visit our website at www.popcatholic.org to learn more about Prince of Peace Catholic Church.

Your name *

Email address *

Name Prefix *

Middle Name *

Enter NA if none.

Prefer to be called Name

If different from Legal First Name

Legal First Name

Given legal first name if different form the First Name entered above.

Maiden Name

Maiden name, if applicable.

Name Suffix

Contact Info

Phone number *

Address *

Additional Personal Info

Would you like to receive the parish e-newsletter, "News to the Pews?" *

Gender *

Birthdate *

Occupation/Job Title *

Company/Employer

Religion *

What is your current religious affiliation

Previous Parish

If you belonged to a previous Catholic Parish, please let us know. Please indicate the parish name and city.

How do you describe your ethnic background? *

What is your primary language? *

Household/Family Info

Family/Household Last Name

(If different from yours)

Family Position/Role *

EG: Husband, Wife (Use Head for unmarried/widowed/single adults and single parents)

Marital status *

Household members

Please add your spouse (if currently married), and each of your children.
***Please note: Children within the household should be under the age of 25. Those who are 25 years of age and older should register separately.

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