St Max Registration Form

Registration/Census Form

Use this form to register, change your address within the parish or to notify the Rectory that you are moving out of the parish.

This form can be filled in online at http://www.stmax.org

If you have children age 3 to 17 that need to be enrolled in Religious Education, please call Barbara Hamburger at (610) 399-9642.

(Use the Tab key to move from field to field)

Please select choice:
Initial Registration
Change of Address Within Parish (just input Family Last Name, New Address and Family Member # 1's First Name)
Moving Out of Parish (just input Family Last Name and Family Member # 1's First Name)

Household Information

Family Last Name

Total # of Family Members

Address

City State Zip Township

Home Telephone # -- Unlisted? Yes No

Marital Status

If Married;

Church of Marriage City

State Date of Marriage

Involved in Religious Education? Yes No

Regularly attending Mass? Yes No

Do you want to receive weekly collection envelopes? Yes No

Individual Family Member Information

Family Member #

First Name Middle Name

Sex - Male Female

Date of Birth City State

Religion

Sacraments Received: (Check all that apply)
Baptism Penance 1st Communion Confirmation

Name of Father Name of Mother

Maiden Name, if applicable

Name of Godparents

Employment Information

Employer

Title

City State Work Telephone #

Education Information

School Name

Grade Level Highest Degree

Please list any special needs

Are you willing to volunteer? Yes No

Please list any special skills or talents