Step 1 of 3 33% Family Information/ Información de familiaDate/ Fecha* MM slash DD slash YYYY Home Phone Number/ Número de casa*Unlisted/ No incluido en el listado* Yes No Marital Status/ Estado civil* Married Single Divorced Separated Widowed Engaged Date of Marriage/ Fecha de casamiento* MM slash DD slash YYYY Church Name/City where married/ Nombre de iglesia/Cuidad donde se caso Head of Household/ Jefe de la familiaSex/Sexo* Male Female Name/ Nombre* First Last Occupation/ Profesión Date of Birth/ Fecha de nacimiento* MM slash DD slash YYYY Work Phone/ Tel. del trabajoCell Phone/ Tel. CelularEmail Address/ Correo electrónico* Status/ Estado Active Catholic Inactive Catholic Sacraments Received/ Sacramentos recibidos*Check to indicate yes Baptism/ Bautismo Confirmation/ Confirmación First Communion/ Primera communión Marriage/ Casamiento Input Spouse's Information?/* Yes No Additional Members Living at Address?/ Miembros adicionales que viven en la direccion?* Yes No Spouse/ EsposaName/ Nombre* First Last Occupation/ Profesión Date of Birth/ Fecha de nacimiento* MM slash DD slash YYYY Work Phone/ Tel. del trabajoCell Phone/ Tel. CelularEmail Address/ Correo electrónico Status/Estado Active Catholic Inactive Catholic Sacraments Received/ Sacramentos recibidos*Check to indicate yes Baptism Confirmation First Communion Marriage General Information/ Información generalSpecial Needs/ Necesidades especiales(Disabled, Homebound, etc.)Address/ Dirección* Street Address Address Line 2 City 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 State ZIP Code Additional Members at Address/Miembros adicionales en la direccionNumber of additional members/ Número de miembros adicionales*Please enter a number from 1 to 8.Additional Member 1/ Miembro adicional #1Name/ Nombre* First Last Sex/ Sexo* Male Female Date of Birth/ Fecha de nacimiento* MM slash DD slash YYYY Occupation/ Profesion Employer or School/Grade Sacraments Received/ Sacramentos recibidos*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Member 2/ Miembro adicional #2Name/Nombre* First Last Sex/ Sexo* Male Female Date of Birth/ Fecha de nacimiento* MM slash DD slash YYYY Occupation/ Profesion Employer or School/Grade Sacraments Received/ Sacramentos Recibidos*Check to indicate yes Baptism/ Bautismo Reconciliation/ Reconciliación Confirmation/ Confirmación First Communion/ Primera Comunión Marriage/ Casamiento Additional Member 3/ Miembro adicional #3Name/Nombre* First Last Sex/ Sexo* Male Female Date of Birth/ Fecha de nacimiento* MM slash DD slash YYYY Occupation/Profesión Employer or School/Grade Sacraments Received/ Sacramentos Recibidos*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Member 4/ Miembro adicional #4Name/Nombre First Last Sex/Sexo* Male Female Date of Birth/Fecha de nacimiento* MM slash DD slash YYYY Occupation/ Profesión Employer or School/Grade Sacraments Received/Sacramentos recibidos*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Member 5/ Miembro adicional #5Name/ Nombre First Last Sex/Sexo* Male Female Date of Birth/Fecha de nacimiento* MM slash DD slash YYYY Occupation/Profesión Employer or School/Grade Sacraments Received/Sacramentos recibidos*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Member 6/Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Occupation Employer or School/Grade Sacraments Received*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Member 7Name First Last Sex* Male Female Date of Birth* MM slash DD slash YYYY Occupation Employer or School/Grade Sacraments Received/Sacramentos recibidos*Check to indicate yes Baptism/Bautismo Reconciliation/Reconciliación Confirmation First Communion Marriage Additional Member 8Name First Last Sex/Sexo* Male Female Date of Birth/Fecha de nacimiento* MM slash DD slash YYYY Occupation/Profesión Employer or School/Grade Sacraments Received/ sacramentos recibidos*Check to indicate yes Baptism Reconciliation Confirmation First Communion Marriage Additional Comments/ Comentarios adicionales:CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
