St. Pius X Parish Community Registration Form

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St. Pius X Parish Community Registration Form

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* Indicates required question

Family Information

Last Name *

Your answer

Address *

Your answer

City & Zip Code *

Your answer

What is your primary phone number and is it your cell phone, work or home number? *

Your answer

Phone Number is unlisted *

Yes

No

Print name & address in Parish Directories? *

Yes

No

List your name(s) in the bulletin as new parishioners? *

Yes

No

Address mail to *

Mr. & Mrs.

Mr. & Ms.

Mr.

Mrs.

Ms.

Method of Contribution

Weekly Envelope

Monthly Envelope

Electronic Funds Transfer

Online/App

Clear selection

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