St. Patrick's North Platte - Parish Registration

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We'd love to welcome you to St. Patrick's!
Please fill out this form to register as a member.

Head of Household/Person 1

Full Name

*

Date of Birth

Catholic? If so mark your sacraments received:

Baptism

Confirmation

First Communion

Marriage

Phone

*

Email

Street Address

*

Mailing Address (if different)

City

*

State

*

Zip Code

*

Spouse/Person 2

Full Name

Date of Birth

Catholic? If so mark the sacraments received:

Baptism

Confirmation

First Communion

Marriage

Phone Number

Email

Others Children/Adults in Your Household

Child/Person 3

Full Name

Date of Birth

Catholic? If so mark the sacraments received:

Baptism

Confirmation

First Communion

Marriage

Child/Person 4

Full Name

Date of Birth

Catholic? If so mark the sacraments received:

Baptism

Confirmation

First Communion

Marriage

Child/Person 5

Full Name

Date of Birth

Catholic? If so mark the sacraments received:

Baptism

Confirmation

First Communion

Marriage

Do you have additional children/members? (If so we'll call you)

Yes

A few last questions...

Are you interested in faith-based education? (check all that apply)

North Platte Catholic Schools (pre-K thru 12)

Becoming Catholic (adults)

Receiving Sacraments (adults)

Receiving Sacraments (children)

Religious Education Registration (children)

Are you interested in the opportunity to be part of our service groups and other ministries?

Yes I'd like more information!

How would you like to support us?

Do you have skills that you may be willing to offer in service?

How else can we help you?

Do not enter anything in this field:

* indicates a required field

Please fill this field.

415 N Chestnut St. | North Platte, NE 69101-6954 | (308) 532-0942

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