St. Mary Catholic Church | Dayton, OH 45410
St. Mary Catholic Church - Dayton, OH  45410
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New Parishioner Registration Form

 
* Fields marked with Required Field are required.
 
   
   
   
           
Check all the Sacraments you have received:
 
  Baptism Eucharist Reconciliation Confirmation Marriage 
           
           
   
 
 
       
           
Marital Status:
  Single  Married  Divorced  Separated   
           
Other Family Member or Spouse
 
   
   
   
       
           
Check all the Sacraments that the other family member or your spouse have received:
 
  Baptism Eucharist Reconciliation Confirmation Marriage 
           
    Number of children living in your household under the age of 18?   
   
List the children in the household Sacraments Received
Childs Name
Date of Birth
( Month Day Year)
Sex
Baptism,  Confirmation,  Eucharist,  Reconciliation
 
 
 
 
 
 
 
 
 

I am interested in one or more of the following: 
           
  Baptism 1st Communion Reconciliation Confirmation Marriage   
           
    Captcha: 


 
   
    Required Field        
           
           
           
 
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