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Registration - English

- I'm New
please note:
- Our parish registrations are used only by our parish and the diocese. In no way do we share the information you give to us with any outside organization.
- To reduce parish operating costs, we will not send offertory envelopes if they have not been utilized in three months or more. This does not affect your parish registration. If you would like to know your Parishioner Number (Envelope Number) for Faith Direct, please contact our office at 904-268-5422.
- By completing this form, if you are currently registered at another parish within the Diocese of St. Augustine, your file will be transferred through the Diocese's database and the previous parish will retain an unregistered copy of your file.
- If you were registered as a child with your family and are now over 25 years of age, you will need to register as an individual.

REGISTRATION &
INFORMATION UPDATE
The maximum number of form submissions has been reached. This form is currently not available.
- Type of Registration REQUIRED
  Type
  Please fill out this field.
- Would you like to receive contribution envelopes? REQUIRED Yes, please. No, not at this time. No, I will be using Faith Direct (online giving) Please fill out this field.
- Registering parishioners automatically receive the bimonthly "St. Augustine Magazine." Opt Out (I do not wish to receive the magazine)
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- Apartment/Unit # Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone Maximum 20 characters Please enter a phone number.
- Primary Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Primary Email Please enter an email address.
- Preferred Language REQUIRED Please fill out this field. Please enter valid data.
- HEAD OF HOUSEHOLD
  
  Title REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Date of Marriage (if applicable) Please enter valid data.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation Please enter valid data.
- Number of Additional Family Members REQUIRED Please fill out this field.
  
  Family Member 1
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 2
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 3
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 4
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 5
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 6
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 7
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 8
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 9
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 10
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 11
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
  
  Family Member 12
  
  Relationship to Head of Household REQUIRED Please fill out this field.
  
  If "Other" is selected, list the relationship Please enter valid data.
  
  Title
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Suffix
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone (if applicable) Maximum 20 characters Please enter a phone number.
  
  Email (if applicable) Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity (Optional) Please enter valid data.
  
  Marital Status REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism First Communion Confirmation None Please fill out this field.
  
  Church of Baptism Please enter valid data.
  
  City of Baptism Please enter valid data.
  
  State/Country of Baptism Please enter valid data.
  
  Occupation / Year in School Please enter valid data.
- Comments:
- Confirmation Email REQUIRED Please fill out this field. Please enter an email address.
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