545 A1A North, Ponte Vedra Beach, FL 32082
904-285-2698
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Our Lady Star of the Sea Catholic Church
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Palmer Catholic Academy
Palmer Catholic Academy Pre-School
Registration Form – Our Lady Star of the Sea
General Information
Family Last Name:
Address Line #1:
Address Line #2:
City:
State:
Zip:
Home Phone #:
Cell Phone #:
Email:
Will you use Offertory envelopes:
Yes
No
Registrant
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birthdate:
Occupation:
Business Phone:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Marital Status:
Married
Married by a Catholic Priest
Single
Widowed
Divorced
Marriage Date:
Spouse
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birthdate:
Occupation:
Business Phone:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Marital Status:
Married
Married by a Catholic Priest
Single
Widowed
Divorced
Marriage Date:
Add a child
Child 1
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 2
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 3
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 4
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 5
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 6
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 7
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 8
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Add a child
Child 9
First Name:
Middle Name:
Last Name (if different)
Title:
---
Mr.
Mrs.
Miss
Ms.
Dr.
Birth Date:
Check all that apply:
Baptized Catholic
1st Communion
1st Penance
Confirmed
Registration Form – Our Lady Star of the Sea