PARISH REGISTRATION – St Mary's Mission

HEAD OF THE FAMILY

House Name*

Name*

Given Name(s)

Surname

Marital Status*

Date of birth*

Date of Marriage

Email address*

Mobile*

Date of Baptism

Postal Address*

Ward*

Please select your current assigned ward from the list. If you do not know, please contact us.

Profession

Parish in Kerala

Diocese in kerala

SPOUSE DETAILS

Name

First

Last

Date of Birth

Mobile

Email address

Profession

Parish in Kerala

Diocese in Kerala

Family Members (Excl. Head of the Family & Spouse)

Full Name

Baptism Name

Gender

Date of Birth

Date of Baptism

First holycommunion

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CANCEL

Full Name

Baptism Name

Gender

Date of Birth

Date of Baptism

First holycommunion

ADD MORE

CANCEL

Full Name

Baptism Name

Gender

Date of Birth

Date of Baptism

First holycommunion

ADD MORE

CANCEL

Full Name

Baptism Name

Gender

Date of Birth

Date of Baptism

First holycommunion

Declaration

I hereby declare that the information provided in this form is complete and accurate to the best of my knowledge and I promise my support, allegiance and co-operation with the church ministries as a registered member of ST Mary’s Syro Malabar Mission, Newcastle.

I AGREE