ST. Mary of the Assumption Catholic Church

14908 Main Street

Upper Marlboro, Maryland  20772

 

Telephone (301) 627-3255

email:  rectory@stmarysum.org

Business Hours for the Rectory 10am - 5pm Monday through Friday

 

Registration
 

Home

 

CONFIDENTIAL

REGISTRATION FORM

 

 

New to Parish    Leaving Parish  Update/Correction 

Household Title :         ( Mr. & Mrs., Mr., Mrs., Ms. )

Mailing Address:

Street    
City    
State Zip Code

 

Residence Address if different than mailing address:

Street    
City    
State Zip Code

Phone     

Family email 

Do not publish phone numbers

Do not publish e-mail

 

 Man's               

Name
D.O.B.     (MM/DD/YYYY)
Religion
Occupation
Race    (optional)

        

Woman's

Name
D.O.B.    (MM/DD/YYYY)
Religion
Occupation
Race    (optional)

 

Marital Status:

Married

  Single

Widowed

Separated

Divorced

If married, is the marriage recognized by the Catholic Church ? ( Y/N )

  Key for Race or Origin
A Asian
B Black - African American
H Hispanic or Latino
W White not of Hispanic orgin
O Other

 Information voluntarily provided about race and/or origin is used

 to plan for and better serve the pastoral needs of the Archdiocese

 

Children (beginning with the oldest)

     Name

Sex

M/F

     D.O.B

(mm/dd/yyyy)

 Race

Baptized

(Y/N)

(Y/N)

Communion

Confirmed

(Y/N)

         School Name/

Occupation

   Grade

Do school age children not attending a Catholic school attend CCD? (Y/N) 

Extended Family or others living in your Household:

     Name

Sex

M/F

     D.O.B

(mm/dd/yyyy)

 Race

Baptized

(Y/N)

(Y/N)

Communion

Confirmed

(Y/N)

         School Name/

Occupation

   Grade

Comments

 

                                                                               

 

 

 

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