MEMBER REGISTRATION
Saint Mary of the Visitation Catholic Church  
52245, Iowa City, 302 East Jefferson Street
Website: icstmary.org Phone: (319) 337-4314

Thank you for taking the time to register as an official member of St. Mary’s. We are glad to have you as part of our community. Be assured of the full benefits of membership at St. Mary’s. You will be added to our mailing list for regular communication, including our parish newsletter, offertory envelopes, and other information pertaining to parish life. In addition, parish membership is necessary to receive Baptism, First Communion, Confirmation and Marriage.
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FAMILY LAST NAME
MAILING ADDRESS
CITY AND ZIP CODE
FIRST AND LAST NAME - HEAD OF HOUSEHOLD
RELATIONSHIP STATUS - HEAD OF HOUSEHOLD
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LEGAL SEX - HEAD OF HOUSEHOLD
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BIRTHDATE - HEAD OF HOUSEHOLD
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DD
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YYYY
RELIGION - HEAD OF HOUSEHOLD
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BAPTISM STATUS - HEAD OF HOUSEHOLD
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CONFIRMATION STATUS - HEAD OF HOUSEHOLD
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EMAIL ADDRESS - HEAD OF HOUSEHOLD
PHONE NUMBER - HEAD OF HOUSEHOLD
CURRENT/LAST OCCUPATION - HEAD OF HOUSEHOLD
PLACE OF EMPLOYMENT - HEAD OF HOUSEHOLD
FIRST AND LAST NAME - SPOUSE
RELATIONSHIP STATUS - SPOUSE
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LEGAL SEX - SPOUSE
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BIRTHDATE - SPOUSE
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DD
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YYYY
RELIGION - SPOUSE
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BAPTISM STATUS - SPOUSE
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CONFIRMATION STATUS - SPOUSE
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EMAIL ADDRESS - SPOUSE
PHONE NUMBER - SPOUSE
CURRENT/LAST OCCUPATION - SPOUSE
PLACE OF EMPLOYMENT - SPOUSE
DATE OF MARRIAGE
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DD
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YYYY
PLACE OF MARRIAGE
WERE YOU MARRIED IN A CATHOLIC CEREMONY, OR WITH CATHOLIC DISPENSATION
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*IF OPTION 2, WOULD YOU LIKE TO BE CONTACTED ABOUT VALIDATING IN THE CHURCH
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PLEASE LIST ANY HOBBIES, SPECIAL INTERESTS OR TALENTS YOU HAVE
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