Parish Registration

Thanks for taking a moment to register your household's information with our parish's office. Please fill out the form as completely as possible and then click submit.

Parish Registration Form

Last Name

First Name

Mailing Address

City, State, Postal Code

Home address if different from mailing address

Cell Phone

Home Phone

Date of Birth

Ethnic Group

Religion

Occupation

Work Phone

Place of Employment

Marital Status

Marriage Date

Spouse Name

Spouse E-mail

Spouse Cell Phone

Spouse Date of Birth

Spouse Occupation

Spouse Work Number

Spouse Place of Employment

Child's Name

Child's Date of Birth

Gender

Male

Female

Ethnic Group

School Attending

Grade in School

Dates/Parish of Baptism:

Dates/Parish of First Communion:

Dates/Parish of Reconciliation:

Dates/Parish of Confirmation:

Child's Name

Child's Date of Birth

Gender

Male

Female

Ethnic Group

School Attending

Grade in School

Dates/Parish of Baptism:

Dates/Parish of First Communion:

Dates/Parish of Reconciliation:

Dates/Parish of Confirmation:

Child's Name

Child's Date of Birth

Gender

Male

Female

Ethnic Group

School Attending

Grade in School

Dates/Parish of Baptism:

Dates/Parish of First Communion:

Dates/Parish of Reconciliation:

Dates/Parish of Confirmation:

Child's Name

Child's Date of Birth

Gender

Male

Female

Ethnic Group

School Attending

Grade in School

Dates/Parish of Baptism:

Dates/Parish of First Communion:

Dates/Parish of Reconciliation:

Dates/Parish of Confirmation:

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Office Manager

rserio@stjosephgreenville.org

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412 Main St, Greenville, MS, United States

662-335-5251

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