Parish Registration

Family Name REQUIRED Please fill out this field. Please enter valid data.

Language (other than English) Please enter valid data.

Physical Address

Street REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Mailing Address

Mailing Address is the same as the Physical Address. REQUIRED YES NO Please fill out this field.
Street Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.

Would you like to subscribe to Idaho Catholic Register? [$20.00 p/year] REQUIRED YES NO Please fill out this field.

Would you like to receive our weekly e-Messenger, emailed each Friday? REQUIRED YES NO Please fill out this field.

Contact Info

Preferred Contact Number REQUIRED Please fill out this field. Please enter valid data.
Husband Cell Phone Please enter valid data.
Wife Cell Phone Please enter valid data.
Preferred Email Address REQUIRED Please fill out this field. Please enter valid data.

List all family members living with you (include last name if different).

Are there any special needs in the family?

St. Pius X CATHOLIC Church