St. John Vianney Catholic Church | Change/Add Personal Information Form

CURRENT INFORMATION:

Full Name*

SJV Envelope # (if known)*

Address (Include apartment #, if applicable)*

Street Address City State ZIP Code

Home Phone*

Primary Family Email*

Enter Email Confirm Email

NEW INFORMATION:

Address (Include apartment #, if applicable)*

Street Address City State ZIP Code

Home Phone Number*

His Cell Phone Number

Her Cell Phone Number

Primary Family Email*

Enter Email Confirm Email

Add Spouse?

Add How Many Children Living at Home?

Add Other Adults in Household?

Spouse

Prefix*

Other Prefix:

First Name*

Middle Name/Initial

Last Name

(If Different than Head of Household)

Maiden Name

Cell Phone Number

Work Phone Number

Email Address

(If different from Primary Email)

Date of Birth*

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Occupation

Ethnicity*

Other Ethnicity:

Date of Wedding*

Married by a Priest/Deacon?*

Yes
No

Children Living at Home (oldest first)

Child 1

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 2

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 3

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 4

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 5

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 6

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 7

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Child 8

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Grade Level (2016-2017)

School Currently Attending

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

OTHER ADULTS IN HOUSEHOLD

Other Adult 1

Relationship to Head of Household*

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Other Adult 2

Relationship to Head of Household*

First Name*

Middle Name/Initial

Last Name

(If different from Head of Household)

Date of Birth*

Gender*

Male
Female

Religion

Religion (if not Catholic):

Sacraments Received

Mark if received

Baptism
1st Penance
1st Communion
Confirmation

Ethnicity*

Other Ethnicity:

Comments:

Change/Add Personal Information Form

CURRENT INFORMATION:

NEW INFORMATION:

Spouse

Children Living at Home (oldest first)

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Child 8

OTHER ADULTS IN HOUSEHOLD

Other Adult 1

Other Adult 2

St. John Vianney

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