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Become a Member

- Become a Member

If you would like to become a member of Christ the King or St Patrick's parish, please complete the form below.
Membership Form
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- Parish REQUIRED Christ the King St Patrick Please fill out this field.
- Family last name REQUIRED Please fill out this field. Please enter valid data.
- Address line 1 REQUIRED Please fill out this field. Please enter valid data.
- Address line 2 Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home phone number Maximum 20 characters Please enter a phone number.
- Number of adult members REQUIRED Please fill out this field.
  
  Adult 1
  
  Parish status REQUIRED
  If you would attend Mass but are unable to do so for physical or health reasons, please mark as "Active"
  Active Inactive Please fill out this field.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Maiden name Please enter valid data.
  
  Title (Mr, Mrs, Miss, Ms, Dr etc) REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (city, state) REQUIRED Please fill out this field.
  
  Marital status Single Married Widowed Separated Divorced
  
  Phone number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email address REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Catholic marriage REQUIRED Yes No Please fill out this field.
  
  Place of Catholic marriage (church, city, state)
  
  Adult 2
  
  Parish status REQUIRED
  If you would attend Mass but are unable to do so for physical or health reasons, please mark as "Active"
  Active Inactive Please fill out this field.
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Maiden name Please enter valid data.
  
  Title (Mr, Mrs, Miss, Ms, Dr etc) REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (city, state)
  
  Marital status Single Married Widowed Separated Divorced
  
  Phone number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email address REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Catholic marriage REQUIRED Yes No Please fill out this field.
  
  Place of Catholic marriage (church, city, state)
- Number of dependent children REQUIRED Please fill out this field.
  
  Dependent child 1
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 2
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 3
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 4
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 5
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 6
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 7
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 8
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 9
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 10
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 11
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 12
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 13
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 14
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 15
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 16
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 17
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 18
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 19
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
  
  Dependent child 20
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle names Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  Place of birth (city, state) REQUIRED Please fill out this field.
  
  High school graduation year REQUIRED Please fill out this field. Please enter an integer (number).
  
  Present school REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism REQUIRED Baptized Catholic Baptized non-Catholic Unbaptized Please fill out this field.
  
  Place of baptism (church, city, state)
  
  First Eucharist REQUIRED Yes No Please fill out this field.
  
  Place of first Eucharist (church, city, state)
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Place of confirmation (church, city, state)
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The Rutland-Wallingford Catholic Community

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