Immaculate Conception
Parishioner Membership Information

Family Name:
Street Address:
City:
State:
Zip:
Phone number:
Unlisted: No Yes
Saint Louis Review: No Yes
Head of Household
HOH First Name Middle Initial:
HOH Preferred Name Nick Name:
HOH Maiden Name:
HOH Birthdate:
HOH Sex: Male Female
Marital Status:
Date of Marriage:
Married by a Priest:
HOH Occupation:
HOH Work Phone Number:
HOH Disability:
HOH Religion:
HOH Date of Baptism:
HOH Date of 1st Communion:
HOH Date of Confirmation:
Spouse
First Name & Middle Initial:
Preferred Name or Nick Name:
Maiden Name:
Birthdate:
Sex: Male Female
Occupation:
Work Phone Number:
Disability:
Religion:
Date of Baptism:
Date of 1st Communion:
Date of Confirmation:
Please list Children under 21 Other adults register individually
Child 1 Full Name:
Child 1 Sex: Male Female
Child 1 Birthdate:
Child 1 Date of Baptism:
Child 1 Date of 1st Communion:
Child 1 Date of Confirmation:
Child 1 School:
Child 2 Full Name:
Child 2 Birthdate:
Child 2 Sex: Male Female
Child 2 Date of Baptism:
Child 2 Date of 1st Communion:
Child 2 Date of Confirmation:
Child 2 School:
Child 3 Full Name:
Child 3 Birthdate:
Child 3 Sex: Male Female
Child 3 Date of Baptism:
Child 3 Date of 1st Communion:
Child 3 Date of Confirmation:
Child 3 School:
Child 4 Full Name:
Child 4 Birthdate:
Child 4 Sex: Male Female
Child 4 Date of Baptism:
Child 4 Date of 1st Communion:
Child 4 Date of Confirmation:
Child 4 School:
Child 5 Full Name:
Child 5 Birthdate:
Child 5 Sex: Male Female
Child 5 Date of Baptism:
Child 5 Date of 1st Communion:
Child 5 Date of Confirmation:
Child 5 School:
Child 6 Full Name:
Child 6 Birthdate:
Child 6 Sex: Male Female
Child 6 Date of Baptism:
Child 6 Date of 1st Communion:
Child 6 Date of Confirmation:
Child 6 School:

Every member of the Church has received a gift for the benefit of the whole community.

Please type the first name of the person next to the skill you will share or the ministry that interests you.

Skills & Talents
Baking or Cooking:
Carpentry:
Computer or Data Entry:
Electrical:
Gardening and Yard work:
Heating and Cooling:
Painting:
Photography:
Plumbing:
Sewing or Quilting:
Telephoning:
Other Skills or Talents:
Education & Youth Ministries
Adult Faith Formation:
Home and School:
LifeTeen program:
Marriage prep:
PSR Teacher or Aide:
RCIA sponsor:
School Board:
Scouts:
Liturgical Ministries
Altar Server:
Choir or Cantor:
Communion at Mass:
Communion to Homes:
Flowers or Decorations:
Funeral Choir:
Greeter or Usher:
Lector:
Liturgy Committee:
Musician:
Organizations & Activities
ADA Worker:
Athletic Association:
Auction:
Bingo:
Blood Drive Worker:
Church Cleaning:
Eucharistic Adoration:
Finance Committee:
Funeral Lunches:
Hospitality:
Knights of Columbus:
Mens Club:
Money Counter:
Our Ladys Sodality:
Parish Council:
Picnic Worker:
Prayer Group:
Prime Timers 50 or older:
Pro Life:
Saint Vincent de Paul:
Stewardship Committe:
Tender Loving Care:
Young Adults 18 to 30: