Cathedral of St. John Berchmans 

                                               Diocese of Shreveport 

 

Family Registration Information                                       
 
   New Parishioner Registration     Census Update             Member since 
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*Home Phone:        Phone unlisted         Fax:    

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If currently married, date of Marriage:    Married by (priest, minister, justice of the peace):   

Church of Marriage:    City, State: 

Member Information 
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*Maiden Name:    *Last Name, if different:   Nickname:

*Relationship:     Degree:       *Gender:       *Birth date:
*Religion:     Occupation:    Location:   Work phone: 
*Cell Phone:     *Email, if different:     

Sacraments BAPTISM   Date: Church: City:    State:     

First Communion   Date: Church: City:    State:

Confirmation  Date: Church: City:    State:     

(Ministry options: Altar Server, Bereavement, Bible Study, Children’s Liturgy, Circle 5, Coffee & Donuts, Environment, Faith Formation, Greeter, Hispanic,

Hearing Impaired, Knights of Columbus, Ladies Altar Society, Lector, Minister of Holy Communion, Music, Nursery, Receptions, RCIA, Visits to the Sick,

Sacramental Prep, School, St. Raphael Guild, St. Vincent de Paul, Usher, Vocations, Welcoming Catholics Home, Young at Heart, Youth)

Current Ministry:  I am interested in information on this Ministry:

 
Member Information

Title:    *Member First Name: *Middle Name/Initial:   

*Maiden Name:    *Last Name, if different:   Nickname:

*Relationship:    Degree:      Gender:      Birth date:
Religion:   Occupation:    Location:   Work phone: 
IF STUDENT    Grade:     School:       
*Cell Phone:     *Email, if different:     

Sacraments  BAPTISM   Date: Church: City:    State:     

First Communion   Date: Church: City:    State:

Confirmation  Date: Church: City:    State:     

Current Ministry:  I am interested in information on this Ministry:

Member Information

Title:   *   Member First Name: *Middle Name/Initial:    

*Maiden Name:    *Last Name, if different:   Nickname:

*Relationship:    Degree:       Gender:        Date of Birth:
Religion:     Occupation:    Location:   Work phone: 
IF STUDENT    Grade:    School:        
*Cell Phone:     *Email, if different:     

Sacraments  BAPTISM   Date: Church: City:    State:     

First Communion   Date : Church: City:    State:

Confirmation  Date: Church: City:    State:     

Current Ministry:  I am interested in information on this Ministry:

Member Information

Title:      *Member First Name: *Middle Name/Initial:    

*Maiden Name:    *Last Name, if different:   Nickname:

*Relationship:    Degree:     Gender:   Date of Birth:
Religion:   Occupation:    Location:   Work phone: 
IF STUDENT    Grade:    School:       
*Cell Phone:     *Email, if different:     

Sacraments  BAPTISM   Date: Church: City:    State:     

First Communion   Date : Church: City:    State:

Confirmation  Date: Church: City:    State:     

Current Ministry:  I am interested in information on this Ministry:


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Thank you for registering at St. John Berchmans Cathedral.