Family Registration Form

Please utilize this form to update your currecnt registration. If you do not know your envelope number,
please complete as a "new registration". We will match up this information to what we have one file.

Click Submit Form to send this information to St. Barbara Church.

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*Required fields

*Registration Option		Register a New Family		Update an Existing Family	*ID/Env:
		Call St. Barbara Church at (724) 744-7474, if you do not know your ID Number or Envelope Number.

Head of Household
Title		*First Name		*Last Name	Suffix
Relationship		Middle Name		Nickname	Maiden Name
Ethnicity		Birth Date		*Gender
Grade/Degree		Language		Marital Status
		*Phone 1	( ) - Unlisted
		*Email 1	Unlisted Unlisted
			Send Email Instead of Mail When Possible

	Spouse
Title		First Name		Last Name	Suffix
Relationship		Middle Name		Nickname	Maiden Name
Ethnicity		Birth Date		Gender
Grade/Degree		Language		Marital Status
		Phone 1	( ) - Unlisted
		Email 1	Unlisted
			Send Email Instead of Mail When Possible

			Family Street Address
		*Line 1
		Line 2
		*City
		*State
		*ZIP

			Family Mailing Address
		Line 1
		Line 2
		City
		State
		ZIP

			Family Phone Numbers
		*Primary	( ) - Unlisted
		Other	( ) - Unlisted
			Email
		*Email	Unlisted
			Send Email Instead of Mail When Possible

	Member 1			Type
Title		First Name		Last Name	Suffix
Relationship		Middle Name		Nickname	Maiden Name
Ethnicity		Birth Date		Gender
Grade/Degree		Language		Marital Status
		Phone 1	( ) - Unlisted
		Email 1	Unlisted
			Send Email Instead of Mail When Possible

Click Submit Form to send this information to St. Barbara Church.

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