Register with our Parish – Parish of St. Ann

Family Last Name*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Are you a permanent resident at Bethany Beach?*

Yes
No

Other Address*

Street Address Address Line 2 City State ZIP Code

Which is your primary address?*

Mailing
Other

Local Phone Number

Other Phone Number

Cell Phone Number*

Email*

Send Email Instead of Mail When Possible?*

Yes
No

Marital Status*

Wife's Maiden Name*

Couple Married by*

Priest
Deacon

Number of Children Living at Home*

Please enter a number from 0 to 15.

Family Information

Only list children living at home. If more than three, please list information in the Additional Information Textbox below. If a child's last name is different than the family name, please list the last name.

Head of Household

Name*

Date of Birth*

Sacraments/Faith Status*

Please Check All That Apply.

Baptized
Catholic
First Communion
Penance
Confirmation
None

Occupation*

(Previous, If Retired)

School Attending (if Student)*

Put 'N/A' if you're not a student

Language

Other than English spoken at home

Sex*

Male
Female

Race*

Spouse

Name*

Date of Birth*

Sacraments/Faith Status*

Please Check All That Apply.

Baptized
Catholic
First Communion
Penance
Confirmation
None

Occupation*

(Previous, If Retired)

School Attending (if Student)*

Put 'N/A' if you're not a student

Language

Other than English spoken at home

Sex*

Male
Female

Race*

Child-1

Name*

Date of Birth*

Sacraments/Faith Status*

Please Check All That Apply.

Baptized
Catholic
First Communion
Penance
Confirmation
None

Occupation*

(Previous, If Retired)

School Attending (if Student)*

Put 'N/A' if you're not a student

Language

Other than English spoken at home

Sex*

Male
Female

Race*

Child-2

Name*

Date of Birth*

Sacraments/Faith Status*

Please Check All That Apply.

Baptized
Catholic
First Communion
Penance
Confirmation
None

Occupation*

(Previous, If Retired)

School Attending (if Student)*

Put 'N/A' if you're not a student

Language

Other than English spoken at home

Sex*

Male
Female

Race*

Child-3

Name*

Date of Birth*

Sacraments/Faith Status*

Please Check All That Apply.

Baptized
Catholic
First Communion
Penance
Confirmation
None

Occupation*

(Previous, If Retired)

School Attending (if Student)*

Put 'N/A' if you're not a student

Language

Other than English spoken at home

Sex*

Male
Female

Race*

Additional Information

Please list any additional information or children living at home.

Additional Information

Please list answers to the questions as they appear above.

Parish Activities

Indicate if interested in participation

Head of Household Interest*

Spouse Interest*

Child 1 Interest*

Child 2 Interest*

Child 3 Interest*

Other Interest*

List Person along with other interest

Disabilities

List Name of Family Member and List Type of Disability (Hearing Impaired, Physically Handicapped, Mentally Handicapped, Blind, Other)

Directions

Directions*

Plese list directions to your Bethany area home to assist the Pastor in reaching your home in an emergency. Please list directions in the space below from St. Ann's to your home.

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Comments

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