St. Patrick, Lucan and Holy Family, London

Primary Member Information

Date Registered (date the form is completed)

Which Parish do you attend?(required)

St. Patrick Lucan Holy Family London

Name(required)

Home Address(required)

City & Province (required)

Postal Code(required)

Main Telephone #(required)

Emergency Telephone #

Email(required)

Date of Birth (Year/Month/Day)

Religion

Sunday Offertory

Offertory Envelope ( please note we have run out of envelopes for this year, we are able to print labels to attach to envelopes that you purchase) Pre- Authorized Giving Not at this time Holy Family Parish accepts donations via Pllenty at dol-holyfamily-mobile.pllenty.com

Occupation

I would like to volunteer at the parish.

Yes No

I would like to receive Our Family Overview (e-Bulletin) and updates.

Yes No

Other Adult Information

Name

Relationship to Primary Member

Main Telephone #

Emergency Telephone #

Date of Birth (Year/Month/Day)

Religion

Occupation

I would like to volunteer in the parish.

Yes No

I would like to receive e-Bulletins and updates.

Yes No

Other Members (living at home)

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

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