Parish Registration

Head of Household:

First & Last Name (required)

Do you use a nickname?

Address (required)

Unit #

City (required)

State (required)

Zip (required)

Name of Development

Phone Number (required)

Your Email (required)

Gender (required)

—Please choose an option—MaleFemale

Title (required)

—Please choose an option—Mr.Mrs.MissMs.Dr.

Birth Date (required)

Marital Status (required)

—Please choose an option—MarriedSingleWidow/WidowerSeparatedDivorced

Occupation

Catholic Sacraments received. Please check all that apply: (required)

Baptized CatholicReconciliation (Confession)First EucharistConfirmationCatholic Marriage

Religion and Sacraments received if not a Baptized Catholic

Other Adults in Household:

First & Last Name

Do you use a Nickname?

Relationship to head of household

Gender

—Please choose an option—MaleFemale

Title

—Please choose an option—Mr.Mrs.MissMs.Dr.

Birth Date

Marital Status

—Please choose an option—MarriedSingleWidow/WidowerSeparatedDivorce

Occupation

Cell Phone

Email Address

Catholic Sacraments Received

Baptized CatholicReconciliation (Confession)First EucharistConfirmationCatholic Marriage

Religion & Sacraments received if not a Baptized Catholic

First & Last Name

Do you use a Nickname?

Relationship to head of household

Gender

—Please choose an option—MaleFemale

Title

—Please choose an option—Mr.Mrs.MissMs.Dr.

Birth Date

Marital Status

—Please choose an option—MarriedSingleWidow/WidowerSeparatedDivorced

Occupation

Cell Phone

Email Address

Catholic Sacraments Received

Baptized CatholicReconciliation (Confession)First EucharistConfirmationCatholic Marriage

Religion & Sacraments received if not a Baptized Catholic

Are you a part time Florida resident?

YesNo

Residence when not in Florida:

Address

City

State

Zip

Phone Number

Children Living At Home:

Do you have children living at home?

YesNo

Child One

First Name

Middle Name

Last Name

Gender

—Please choose an option—MaleFemale

Birth Date

Please check which Sacraments received:

Baptized CatholicReconciliation (Confession)First EucharistConfirmation

Child Two

First Name

Middle Name

Last Name

Gender

—Please choose an option—MaleFemale

Birth Date

Please check which Sacraments received:

Baptized CatholicReconciliation (Confession)First EucharistConfirmation

Child Three

First Name

Middle Name

Last Name

Gender

—Please choose an option—MaleFemale

Birth Date

Please check which Sacraments received:

Baptized CatholicReconciliation (Confession)First EucharistConfirmation

Child Four

First Name

Middle Name

Last Name

Gender

—Please choose an option—MaleFemale

Birth Date

Please check which Sacraments received:

Baptized CatholicReconciliation (Confession)First EucharistConfirmation

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Stewardship

We record all identifiable gifts. Any donations totaling over $250.00 in any tax year will be acknowledged with a tax contribution statement in January.

What is your preference for tithing?

—Please choose an option—Weekly EnvelopesCash/Check via Offertory BasketE-giving

If you choose weekly envelopes you will receive a postcard letting you know when they are ready for pick up.

If you would like to make contributions by credit card or e-check we offer online giving using this secure website powered by WeShare. Click on the "Online Giving " button on our home page.

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Ministries

Our Lady of Light has many ministries in need of your time and talents. Would you like information on volunteering?

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Are there any special circumstances we need to be aware of in order to serve you?

Subject

Your Message

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