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Family Registration FORM

- The maximum number of form submissions has been reached. This form is currently not available.
  
  For questions or concerns, please call the office at 905-278-2058 or email Adriene at [email protected]
  
  For questions relating to Donation Envelopes, please contact Marilyn by calling the office or emailing [email protected].
  
  First Name REQUIRED
  Type in your first name in this box
  Please fill out this field. Please enter valid data.
  
  Middle Name(s)
  Type in your middle name(s) in this box
  Please enter valid data.
  
  Last Name REQUIRED
  Type in your last name in this box
  Please fill out this field. Please enter valid data.
  
  Address REQUIRED
  Type in your home address in this box
  Please fill out this field. Please enter valid data.
  
  City REQUIRED
  Type in the city you are currently residing in
  Please fill out this field. Please enter valid data.
  
  Province REQUIRED
  Select which province you currently reside in by clicking the drop down menu
  Please fill out this field.
  
  Postal Code REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters
  Type in your phone number in this box
  Please fill out this field. Please enter a phone number.
  
  Email REQUIRED
  Type in your email in this box
  Please fill out this field. Please enter an email address.
  
  SPOUSE
  
  First Name REQUIRED
  Type in your first name in this box
  Please fill out this field. Please enter valid data.
  
  Middle Name(s)
  Type in your middle name(s) in this box
  Please enter valid data.
  
  Maiden Name
  Type in your maiden name in this box
  Please enter valid data.
  
  Last Name REQUIRED
  Type in your last name in this box
  Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Number of Children REQUIRED
  Indicate the amount of children you have and enter in their information below
  Please fill out this field.
  
  Child 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 5
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 6
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 7
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 8
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 9
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 10
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 11
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Child 12
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Number of Additional Family Members in Household REQUIRED
  If you have grandparents or other relatives living within your household fill in this section
  Please fill out this field.
  
  Family Member 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Family Member 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Family Member 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Family Member 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  I want to sign up for...
  Choose one of the three (3) options below
  Donation Envelopes Pre-Authorized Giving Online Donations
  
  More about Online Donations and Pre-Authorized Giving.
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  Questions or Comments
  If you have comments or questions please type them in this box
  
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St. Mary Star of the Sea

Roman Catholic Church, Mississauga ON

Family Registration FORM