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Welcome to Our Lady of the Assumption Parish! To register, please fill out this form.

*Family Name: 
*Title: 
*Mailing Address: 
*City:     *State:    *Zip:
Street Address: 
City:     State:    Zip:
Phone: 
*Email: 
Will Use Envelopes:        Marital Status:
If Married, Marriage Date: 
Is your marriage recognized by the Catholic Church?
  Head of Household Spouse
*First Name:
*Last Name:
Maiden Name:
Gender:
Religion:
Occupation:
Work Phone:
Birth Date:
Baptismal Date:
Parish/City of Baptism:
Eucharist:
Confirmation:
 
Please fill out for individuals living in your household:
  Dependant 1 Dependant 2
First Name:
Last Name:
Relation:
Gender:
Religion:
Occupation:
Work Phone:
Birth Date:
Baptismal Date:
Parish/City of Baptism:
Eucharist:
Confirmation:
School Attending:
Grade Level:
 
  Dependant 3 Dependant 4
First Name:
Last Name:
Relation:
Gender:
Religion:
Occupation:
Work Phone:
Birth Date:
Baptismal Date:
Parish/City of Baptism:
Eucharist:
Confirmation:
School Attending:
Grade Level:
 
  Dependant 5 Dependant 6
First Name:
Last Name:
Relation:
Gender:
Religion:
Occupation:
Work Phone:
Birth Date:
Baptismal Date:
Parish/City of Baptism:
Eucharist:
Confirmation:
School Attending:
Grade Level:
 
 
  Our Lady of the Assumption
5057 Cottage Way
Carmichael, CA 95608
(916) 481-5115

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