Saint Rita Catholic Church and School in Webster, NY

Family Last Name: *

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Is this number unlisted? No Yes

Married by a priest or deacon? Yes No

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Would you like to receive weekly offertory envelopes? Yes No No, but please tell me more about online giving options

Does anyone in your family have a special need (homebound visits, to make a sacrament, faith formation classes, a marriage blessing, etc.):

Adult's First Name: *

Maiden Name:

Title:

Gender: * Male Female

Date of birth: *

Email address:

Cell Phone #:

Marital status:

Occupation:

Baptized? Yes No

If yes, what religion?

Made First Communion? Yes No

Confirmed? Yes No

Spouse/Other Adult's First Name (and last name if different from family name):

Maiden Name:

Title

Gender: Male Female

Date of birth:

Email address:

Cell Phone #:

Marital status:

Occupation:

Baptized? Yes No

If yes, what religion:

Made First Communion? Yes No

Confirmed? Yes No

First Name of Additional Adult/Child living in household (and last name if different than family name):

Gender: Male Female

Date of birth:

School attends/attended:

Grade:

Attends Faith Formation: Yes No

Baptized? Yes No

If yes, what religion?

Made First Communion? Yes No

Confirmed? Yes No

First Name of Additional Adult/Child living in household (and last name if different than family name):

Gender: Male Female

Date of birth:

School attends/attended

Grade:

Attends Faith Formation: Yes No

Baptized? Yes No

If yes, what religion?

Made First Communion? Yes No

Confirmed? Yes No

First Name of Additional Adult/Child living in household (and last name if different than family name):

Gender Male Female

Date of birth:

School attends/attended

Grade:

Attends Faith Formation: Yes No

Baptized? Yes No

If yes, what religion?

Made First Communion? Yes No

Confirmed? Yes No

First Name of Additional Adult/Child living in household (and last name if different than family name):

Gender: Male Female

Date of birth:

School attends/attended:

Grade:

Attends Faith Formation: Yes No

Baptized? Yes No

If yes, what religion?

Made First Communion? Yes No

Confirmed? Yes No

If you have additional family members, please submit this form and start a new one with the other members (you can skip head of household and spouse). Yes, I have more members to add. All set - this is everyone in my household.