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Parish Registration Form
Which parish are you registering with?
*
St. Joseph Church (Roseburg)
St. Francis Xavier Church (Sutherlin)
Head of Household
Full Name
Marital Status
Sex
Date of Birth
Phone
Email
Home Address
Occupation (former if retired)
Place of Employment (former if retired)
Please list: Catholic or Non-Catholic / Baptized (Y/N) / First Communion (Y/N) / Confirmed (Y/N) / Mass attendance / Language spoken — separated by commas.
Spouse
Full Name
Marital Status
Sex
Date of Birth
Phone
Occupation (former if retired)
Place of Employment (former if retired)
Please list: Catholic or Non-Catholic / Baptized (Y/N) / First Communion (Y/N) / Confirmed (Y/N) / Mass attendance / Language spoken — separated by commas.
Dependant Children Living at Home
Number of Children in Household
Parish Involvement
Preferred Mass Time
Interest in Volunteering
Choir
Ushering
Hospitality
Community kitchen
Religious Education
Cemetery
Other
Previous Parish (If Transferring)
Giving Preference
Preference
Submit
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