Parishioner Registration Form Please fill out this form to become a parishioner at The Basilica of St Mary Star of the Sea. Applicant InformationName(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Date of Birth(Required) MM slash DD slash YYYY Sex(Required) Male Female Religion(Required) Catholic Protestant/Christian Jewish Attend Church?(Required) Regularly Frequent Sometimes Marital Status(Required) Married by Priest Married Civil Single Separated Widow Widower Divorced Date of MarriageIf married, date of Marriage MM slash DD slash YYYY Baptized(Required) Yes No Communion(Required) Yes No Confirmation(Required) Yes No Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Seasonal Address?(Required) Yes No Self/Spouse Maiden Last Name Spouse InformationSpouse's Name First Last Spouse's Email Enter Email Confirm Email Spouse's PhoneSpouse Date of Birth MM slash DD slash YYYY Spouse Sex Male Female Spouse Religion Catholic Protestant/Christian Jewish Spouse Attends Church? Regularly Frequent Sometimes Spouse Baptized Yes No Spouse Communion Yes No Spouse Confirmation Yes No Children InformationChild 1 Name First Last Child 1 SacramentsPlease type in Baptism, Communion, Confirmation, Marriage, etc. Child 2 Name First Last Child 2 SacramentsPlease type in Baptism, Communion, Confirmation, Marriage, etc. Child 3 Name First Last Child 3 SacramentsPlease type in Baptism, Communion, Confirmation, Marriage, etc. Child 4 Name First Last Child 4 SacramentsPlease type in Baptism, Communion, Confirmation, Marriage, etc. Child 5 Name First Last Child 5 SacramentsPlease type in Baptism, Communion, Confirmation, Marriage, etc. Envelope #(Required)YesNoAdditional InformationEmailThis field is for validation purposes and should be left unchanged. Δ