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FAMILY INFORMATION

Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Mailing Name (ie Mr. & Mrs. John Doe) REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
Address 2 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.
Primary Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Family Email REQUIRED Please fill out this field. Please enter an email address.
Emergency Contact Name Please enter valid data.
Emergency Contact -Relation Please enter valid data.
Emergency Contact Phone Number Maximum 20 characters Please enter a phone number.
Permission to publish phone, address, email in Parish directory: REQUIRED Yes Publish Phone Yes Publish Email Yes Publish Address Please fill out this field.

Would you like to receive email updates and Flocknote emails from St. James REQUIRED Yes No Please fill out this field.

Were you a previous member at St. James REQUIRED Yes No Please fill out this field.

Current Parish Please enter valid data.

Marital Status

Marital Status REQUIRED Single Married Seperated Divorced Annulled Please fill out this field.
Wedding Date Please enter a date.
Married by a Catholic Priest or Deacon? Yes No
Wedding Church Name Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Celebrant Name Please enter valid data.

HUSBAND (OR SINGLE MALE)

WIFE (OR SINGLE FEMALE)

St. James