Saint Patrick, Lucan and Holy Family, London

Primary Member Information

Date Registered (date the form is completed)

Which Parish do you attend?(required)

Saint Patrick, Lucan Holy Family, London

Name

Home Address

City & Province

Postal Code

Main Telephone #

Emergency Telephone #

Date of Birth (Year/Month/Day)

Religion

Sunday Offertory

Offertory Envelope Pre-Authorized Giving e-Transfer (Saint Patrick – stpatlucan@dol.ca) (Holy Family – hfparish@dol.ca) Holy Family Parish accepts donations via Pllenty at dol-holyfamily-mobile.pllenty.com

Occupation

I would like to volunteer at the parish.

Yes No

I would like to be added to the mailing list to receive the Family Connection (e-Bulletin) and updates.

Yes No

Other Adult Information

Name

Relationship to Primary Member

Main Telephone #

Emergency Telephone #

Date of Birth (Year/Month/Day)

Religion

Sacraments Received in the Catholic Church

Occupation

I would like to volunteer in the parish.

Yes No

I would like to receive e-Bulletins and updates.

Yes No

Other Members (living at home)

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

Name

Date of Birth (Year/Month/Day)

Relationship to Primary Member

Religion

Sacraments Received

Baptism First Communion First Reconciliation Confirmation

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Registration Form

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