Community Registration Form

Head of Household Contact Information

Head of Household Name *

First

Last

DoD / Service Status *

Active Duty
Retired
DoD Civilain

Service Branch *

Registration Type *

New
Update
Moving/PCS

Location *

MPC
AMR

Primary Contact Email *

Primary Phone

Phone Type

Home
Work
Cell

Marital Status *

Single
Married
Engaged

Do you have children or an adult dependent in your household?

How long have you been attending?

Less than a year
1-2 years
2-3 years
More than 3 years

Family Memeber Information

Will not display if "Single" marital status is selected.

Spouse Name

First

Last

DoD / Service Status

Active Duty
Retired
DoD Civilain
Military Spouse

Service Branch

Sacrament of Marriage//

Child 1

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

Child 2

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

Child 3

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

Child 4

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

Child 5

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

Child 6

First

Last

Sacraments Received

Baptism
First Communion
Confirmation

I would like to register my child / children for R.E.

Community Registration Form

Head of Household Contact Information

Family Memeber Information

Ministry Opportunities