Welcome to our parish. Please complete the form below.

Family Information

Family Last Name (please note if you are a Jr., III, etc.) REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

Zip Code REQUIRED Please fill out this field. Please enter valid data.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Head of Household

First & Middle Name Please enter valid data.

Date of Birth (mm/dd/yyyy) Please enter valid data.

Occupation Please enter valid data.

Cell Phone Please enter a phone number.

Email (for OLL use only) Please enter an email address.

First, Middle & Maiden Name Please enter valid data.

Date of Birth (mm/dd/yyyy) Please enter valid data.

Occupation Please enter valid data.

Cell Phone Please enter a phone number.

Email (for OLL use only) Please enter an email address.

Were you married by a Catholic Priest? Yes No

Would you like contribution envelopes sent to you? REQUIRED Yes No Please fill out this field.

Please list all children (Date of Birth, First and Middle Name, Baptized Y or N, Attend OLL School.)

Are you a widow or widower? Yes No

Are you single? Yes No

Are you interested in Religious Education for you or a member of your family? Yes No

Are you interested in learning more about OLL ministries and volunteer opportunities? Yes No

Any special needs children? Yes No

Please list any other family member living in your household, i.e. parents, grandparents, etc.? (Name and Relationship)

Would you like a visit from a priest or deacon? Yes No

Would you like your house blessed? Yes No

Please list any special prayer intentions here.

Would you like for someone to pray with you? Yes No

Form Completed By REQUIRED Please fill out this field. Please enter valid data.