Parish Online Registration Form

Please complete this form to register at one of the Roman Catholic Parishes of Cluster 22 -- St. Bartholomew (Cape Elizabeth), St. John & Holy Cross (South Portland), and St. Maximilian Kolbe (Scarborough).

For more information or assistance, please contact the parish office 207-883-0334, julie.cannon@portlanddiocese.org).

Family Information

Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
City / State / Zip Please enter valid data.
Home Phone REQUIRED Please fill out this field. Please enter valid data.
Family Email Please enter valid data.
Alternate Email Please enter valid data.
Previous Parish Please enter valid data.
How would you like to contribute to your parish? REQUIRED Envelope Cash without envelopes Online/ WeShare Please fill out this field.
Comments Please enter valid data.

Please list all adults and children under 21 currently living in the home (for example, grandparents, college students, etc.) . All adults over the age of 22 living in the home should be included in the "Other Adult Information which follows the Child Information section at the bottom.

Primary Adult Information

Title REQUIRED
Select One
Please fill out this field.
First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name
If Applicable
Please enter valid data.
Suffix Please enter valid data.
Personal Email
Include if different from above
Please enter valid data.
Occupation Please enter valid data.
Place of Employment Please enter valid data.
Cell Phone Please enter valid data.
Gender REQUIRED Please fill out this field.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Marital Status REQUIRED Please fill out this field.
Date of Marriage Please enter valid data.
Religion REQUIRED Catholic Other Please fill out this field.
Other Religion
If not Catholic
Please enter valid data.
Baptized REQUIRED Yes No Please fill out this field.
Confirmed REQUIRED Yes No Please fill out this field.
First Communion REQUIRED Yes No Please fill out this field.

Spouse Information

Title
First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Maiden Name Please enter valid data.
Suffix Please enter valid data.
Personal Email Please enter valid data.
Occupation Please enter valid data.
Place of Employment Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Marital Status REQUIRED Please fill out this field.
Date of Marriage Please enter valid data.
Religion Catholic Other
Other Religion Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No

Child 1 Information

First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Suffix Please enter valid data.
Personal Email Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Religion Catholic Other
Other Religion
If religion other than Catholic
Please enter valid data.
School
Please list child's current school
Please enter valid data.
Grade
Please list child's current grade
Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No

Child 2 Information

First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Suffix Please enter valid data.
Personal Email Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Religion Catholic Other
Other Religion
If religion other than Catholic
Please enter valid data.
School
Please list child's current school
Please enter valid data.
Grade
Please list child's current grade
Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No

Child 3 Information

First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Suffix Please enter valid data.
Personal Email Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Religion Catholic Other
Other Religion
If religion other than Catholic
Please enter valid data.
School
Please list child's current school
Please enter valid data.
Grade
Please list child's current grade
Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No

Child 4 Information

First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Suffix Please enter valid data.
Personal Email Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Religion Catholic Other
Other Religion
If religion other than Catholic
Please enter valid data.
School
Please list child's current school
Please enter valid data.
Grade
Please list child's current grade
Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No

Other Adult Information

Title
First Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Maiden Name Please enter valid data.
Suffix Please enter valid data.
Relationship to Primary Adult Please enter valid data.
Personal Email Please enter valid data.
Work Phone Please enter valid data.
Cell Phone Please enter valid data.
Gender
Date of Birth Please enter valid data.
Marital Status REQUIRED Please fill out this field.
Date of Marriage Please enter valid data.
Religion Catholic Other
Other Religion Please enter valid data.
Baptized Yes No
Confirmed Yes No
First Communion Yes No