Become a Member of Saint Benedict Cathedral Parish

Parish Registration Form

Family Last Name*
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Adult #1*
First Last
Nickname (Adult #1)
Date of Birth (Adult #1)*
Date Format: MM slash DD slash YYYY
Religion (Adult #1)*
Occupation (Adult #1)
Employer (Adult #1)
Education/School (Adult #1)
Email (Adult #1)*
Work Phone (Adult #1)
Cell Phone (Adult #1)
Marital Status*
Type of Wedding (if applicable)
Date of Marriage
Date Format: MM slash DD slash YYYY
Click to Add Another Adult
- Add Adult
Adult #2*
First Last
Nickname (Adult #2)
Date of Birth (Adult #2)*
Date Format: MM slash DD slash YYYY
Religion (Adult #2)*
Occupation (Adult #2)
Employer (Adult #2)
Education/School (Adult #2)
Email (Adult #2)*
Work Phone (Adult #2)
Cell Phone (Adult #2)
Do you have children in your household you want to register?*
- Yes
- No
Child(ren) Registration
Please provide the following information for each child:
* Full Name (First, Middle, Last)
* Nickname
* Date of Birth
* Religion
* School Currently Attending