Flocknote Facebook Instagram

Parish Registration

- Any Catholic may register as a parishioner of Saint Barnabas. Simply submit your information through the form below. You will be contacted to confirm details and to finalize the registration process. Thank you for your time and interest!
- Registration Form
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Personal Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  I am... REQUIRED a Catholic a baptized non-Catholic not baptized Please fill out this field.
  
  Church of Baptism/Reception
  
  If you were baptized as a Catholic or received into full communion with the Catholic Church, please supply the following information about the parish where you were baptized or received.
  
  Name of Parish of Baptism/Reception Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Date of Baptism Please enter a date.
  
  Family
  
  Marital Status REQUIRED Single Married Widowed Divorced/annulled Please fill out this field.
  
  Name of Spouse (if married) Please enter valid data.
  
  Name(s) of Child(ren), if applicable
  
  Request for Registration
  
  By checking the box labed "I Agree" and submitting this form, I hereby indcate that all the information contained submitted in this form is accurate and true, to the best of my knowledge and ability, and I hereby manifest my desire to be registered as a parishioner of Saint Barnabas Catholic Church.
  I Agree Please select this field.
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.