• Registration for Divine Mercy Parish/Registración para la parroquía de la Divina Misericordia

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  • Today's Date/La fecha de hoy REQUIRED Please fill out this field. Please enter a date.
  • Last Name/Apellido REQUIRED Please fill out this field. Please enter valid data.
  • Name of Male Head of Family/Nombre del hombre Please enter valid data.
  • Name of Female Head of Family/Nombre de la Mujer Please enter valid data.
  • Address/Dirección REQUIRED Please fill out this field. Please enter valid data.
  • City, State Zip/Cuidad, Estado Código Postal REQUIRED Please fill out this field. Please enter valid data.
  • Home Telephone/Teléfono de la casa Maximum 20 characters Please enter a phone number.
  • Man's Cell phone/Cellular del hombre Maximum 20 characters Please enter a phone number.
  • Women's Cell Phone/Cellular de la Mujer Maximum 20 characters Please enter a phone number.
  • Email/Correo Electrónico Please enter valid data.
  • How you would like a letter addressed to you? (ex: Mr & Mrs. John Smith)/¿Cómo le gustaría una carta dirigida a usted? (ex: Sr. y Sra. Jose Gonzales) REQUIRED Please fill out this field. Please enter valid data.
  • Marital Status/Estado Civil REQUIRED Single/Sotero(a) Married in the Church/Casados por la Iglesia Civilly Married/Casados por civil Living Together/Unión Libre Please fill out this field.
  • (If applicable) Date of Marriage/Si corresponde (fecha de matrimonio) Please enter a date.
  • Were either one of you married to someone else previously?/¿Alguno de ustedes estuvo casado con otra persona anteriormente? REQUIRED Yes/Si No/No Please fill out this field.
  • Publish Telephone Number in a Parish Directory?/ Yes, you can publish our telephone number(s) in a parish directory/Sí, se puede publicar nuestra numeros de teléfono(s) en un directorio parroquial  No, do not publish our telephone numbers in any parish directory/ No, no publique nuestros números de teléfono en ningún directorio parroquial.
  • Publish Address in Directory?/Publicar dirección en el directorio? REQUIRED Yes, you can publish our address in a parish directory/Sí, se puede publicar nuestra dirección en un directorio parroquial / No, do not publish our address in any parish directory/ No, no publique nuestra dirección en ningún directorio parroquial. Please fill out this field.
  • We prefer communication to us in this language/ Preferimos comunicarnos en este idioma REQUIRED English Español Please fill out this field.

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