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Welcome!

- I'm New!
  - Welcome!
  - Becoming Catholic

Are you new to Kokomo or St. Joan?
If so, we want to meet you!
If you would like more information about our parish, please visit our pastorate office or call us at 765-865-9960. If you're ready to register you/ your family as parishioners, please fill out the form below and we will contact you for more information.

Why register as a parishioner?
Becoming a registered and active parishioner at St. Patrick is vital to your faith life and that of your parish family. It is important that you keep your information current and contact the parish office any time you update your information.

Registered and active parishioners:
- receive year-end statements of giving for tax records
- can receive letters of eligibility from the parish to be a Sponsor/Godparent and for the reception of Sacraments
- receive important mailings, like Lenten/Easter and Advent/Christmas calendars
- feel more connected to others in the parish
This form is not accepting responses at this time.
- Family Registration
  Please fill out the following information for your household and for each member of your household.
- Please confirm the parish where you would like to register: REQUIRED Please fill out this field.
- Head(s) of Household Please enter valid data.
- Home Address
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  Zipcode REQUIRED Please fill out this field. Please enter valid data.
- Home phone number Please enter valid data.
- How many people are in your family? REQUIRED Please fill out this field.
  
  Family member 1
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 2
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 3
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 4
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 5
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 6
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 7
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 8
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 9
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
  
  Family member 10
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial/Name REQUIRED Please fill out this field. Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child, etc.) Please enter valid data.
  
  Religion Please enter valid data.
  
  Baptized? REQUIRED Please fill out this field.
  
  Year & Parish/Place of Baptism Please enter valid data.
  
  Sacramental Status REQUIRED Please fill out this field.
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Individual email address Please enter valid data.
  
  Marital Status
  
  Religious Education In Catholic Schools In Religious Education (K-8 Family Catechesis) Interested in Adult Education Interested in Becoming Catholic
  
  Special Needs (if any) Please enter valid data.
- If Heads of Household are married:
  
  Date of Marriage Please enter valid data.
  
  Married in the Catholic Church?
  
  Married with Bishop's Permission?
- If transferring from another parish, please let us know where you are coming from:
  
  Parish, City: Please enter valid data.
- Is there anything else you would like to share with us?
Submit

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Family Registration