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Join the Catholic Community of St. Francis Xavier

Note: A red ( * ) means the field is required


* Family Last Name:
* Home Phone Number:
* Street Address:
* City or Town:
* Zip Code:
Mailing Address (if different from above):

Family e-mail address:
May we include your phone and address in our parish directory?: Yes No
Do you want to use electronic transfer of funds? (if yes, please call the Parish Office): Yes No
Marital Status:
Date of wedding (mm/dd/yyyy):
Wife's Maiden Name:
If married & want our mailings addressed other than "Mr. & Mrs." please indicate title here:

Head of Household Information:

Male:
Full Name:
Preffered Name:
Date of Birth (mm/dd/yyyy):
Please indicate religion:
Baptized? Yes No
RCIA? Yes No
Confirmed? Yes No
Occupation (please be specific):
Work phone:
Cell phone:
Email address:
Female:
Full Name:
Preffered Name:
Date of Birth (mm/dd/yyyy):
Please indicate religion:
Baptized? Yes No
RCIA? Yes No
Confirmed? Yes No
Occupation (please be specific):
Work phone:
Cell phone:
Email address:
Are there any special needs for you or your spouse?

Do you wish to receive the Catholic Review (Archdiocesan Newspaper): Yes No

Children Information:

First Child:
Child's Name:
Preferred Name:
Birth Date (mm/dd/yyyy):
Gender: Male Female
Please indicate Religion:
Baptized? Yes No
First Eucharist? Yes No
Confirmed? Yes No
Current grade in school:
Current School attending:
Special Needs?


Second Child:
Child's Name:
Preferred Name:
Birth Date (mm/dd/yyyy):
Gender: Male Female
Please indicate Religion:
Baptized? Yes No
First Eucharist? Yes No
Confirmed? Yes No
Current grade in school:
Current School attending:
Special Needs?


Third Child:

Fourth Child:

Fifth Child:

Time & Talent Stewardship - A Way of Life

Please check any of the following ministries or commitees that you would like to receive more information on

Liturgical Ministries
Altar Guild
Altar Servers
Baptism Preparation Ministry
Hospitality at Mass
Environment & Art
Eucharistic Ministers
Greeters
Lectors
Music
Nursery
God's Little Lambs
Sacristans
Faith Formation
Adult Faith Formation
Sponsor Couple Marriage Prep
RCIA & RCIC Team Members
Middle School
Youth Ministry
Family Catechesis
Summer Camp Helpers
Bereavement
City of God Prayer Group
Confirmation
Bible Studies
Outreach Ministries
Beans & Bread Casseroles
Project Share
Our Daily Bread Sandwich Making
UCAN (United Churches Assistance Network)
Bingo at Springfield State Hospital
Giving Tree
Adopt-a-Family
Prison Ministry
Parish Committees
Community Activities
Facilities & Grounds
Faith Formation
Finances
Gospel of Life
Liturgy
Mission & Planning
Outreach & Advocacy
Youth Ministry