Registration Form to download and mail to the Parish office Download Online Fillable Form Date* Date Format: MM slash DD slash YYYY Head of HouseholdName* First Last NicknameCell #*Home Phone #Unlisted*YesNoEmail*(for parish use only) Date of Birth*Sacraments Received*Please check if received Baptism First Communion Confirmation None of the above Previous OccupationRetired?* Yes No Mass Attendance*RegularlyOccasionallySeldomMarital Status?* Married Single Widowed Divorced Wedding Anniversary date*Input Spouse or Household Member Information?*Please note - You must include your spouse's information if you would like them included on the account. YesNoSpouse InformationName* First Last Nick NameCell #*Home #Unlisted?*YesNoEmail*(for parish use only) Date of Birth*Sacraments Received*Please check if received Baptism First Communion Confirmation None of the above Previous OccupationRetired?* Yes No Marital Status* Married Single Widowed Divorce General InformationFlorida Address* Street Address Address Line 2 City ZIP Code Village of Residence*Please check*Full-time ResidentPart-time ResidentUpdating Current RegistrationMonths Usually Spent in Florida*Alternate Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Would you like to receive envelopes?*YesNoOnline Giving If you would like to start giving offertory donations online please visit www.faithdirect.net and input our Parish code FL914 Language*EnglishBilingualAre their members of the household of a different religion?*This is for informational and inclusion purposes only. Yes No Please indicate which faith and which member of the household*Interest/Talents/Skills(For Informational Purposes Only)Interests/Talents/SkillsChoose all that apply Computer Data Entry Carpentry Event Planning Medical Law Enforcement Education Outside Grounds Additional Household Members?*YesNoAdditional Household MembersName* First Last Relationship*Birth Date* Date Format: MM slash DD slash YYYY Sacraments Received*Please check if received Baptism First Communion Confirmation Additional Member*YesNoAdditional Family Member 2Name* First Last Relationship*Birth Date* Date Format: MM slash DD slash YYYY Sacraments Received*Please check if received Baptism First Communion Confirmation Additional InformationHow long have you been in this area?*How long have you been attending St. Vincent de Paul's Catholic Church?*Are there homebound members who are prevented from attending mass?*YesNoPlease give us their nameWould they like Communion brought to their home?YesNoMass Time Preference*Saturday 4pmSaturday 6pmSunday 8amSunday 10amSunday 12 NoonSunday 2pm (in season)Additional InformationEmergency Contact Outside of HouseholdName* First Last Relationship*City*State*Emergency Contact Phone Number*CAPTCHANameThis field is for validation purposes and should be left unchanged.
