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St. Patrick Catholic Church
Canby, OR
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Online Registration Form
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Online Registration Form/Forma de Registracion
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St. Patrick Cemetery
Thank you for taking the time to register/ update your family information at St. Patrick, Canby.
Gracias por darse el tiempo para registrarse o actualizar la informacion de su familia en la Parroquia de San Patricio.
The maximum number of form submissions has been reached. This form is currently not available.
Family Information / Información Familiar
Family Last Name / Apellido de la Familia
REQUIRED
Please fill out this field.
Please enter valid data.
Street Address/PO Box - Dirección o PO Box
REQUIRED
Please fill out this field.
Please enter valid data.
Apt# / Apartamento #
Please enter valid data.
City
REQUIRED
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Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
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NC
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NE
NH
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NM
NV
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OK
OR
PA
PR
PW
RI
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SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
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Zip
REQUIRED
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Please enter a zip code.
Phone Number/ # de Teléfono
REQUIRED
Please fill out this field.
Please enter a phone number.
Unlisted? Ya esta registrado?
REQUIRED
Yes
No
Please fill out this field.
Family Email/ Correo Electrónico de la Familia
REQUIRED
Please fill out this field.
Please enter an email address.
Member Infomation/ Información de cada miembro de la Familia
Please fill out Member Information for each family member.
Por favor llene los espacios con la informacion de cada miembro de su familia
Number of Additional Family Members/Numero de miembros de su familia
REQUIRED
Please fill out this field.
Family Member/Miembro de su Familia 1
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 2
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 3
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 4
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 5
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 6
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 7
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 8
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 9
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 10
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 11
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
Family Member/Miembro de su Familia 12
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Title/ titulo
None
Mr. / Sr.
Mrs. / Sra.
Miss / Srta.
Ms.
Dr.
Status
Head of Household / Responsable de la Casa
Spouse / Esposo/a
Child / Niño/a
Friend / Amigo/a
Other / Otro
Cell Phone / Celular
REQUIRED
Please fill out this field.
Please enter a phone number.
Work Phone / Tel del Trabajo
Please enter a phone number.
Ext. / Extension
Please enter valid data.
Email Address / Correo Electronico
Please enter an email address.
Current Mariage Status / Estado Marital
Married / Casado
Single / Soltero/a
Widow / Viudo/a
Divorced / Divorcidao/a
Annulment / Anulación matrimonial
Other / Otro
Religion / Religión
Please enter valid data.
Birthdate / Fecha de Nacimiento
REQUIRED
Please fill out this field.
Please enter valid data.
Language other than English / Idioma Aparte del Ingles
Please enter valid data.
Employer / Empleador
Please enter valid data.
Occupation / Ocupación
Please enter valid data.
Sacraments / Sacramentos
Baptism / Bautizado
Yes / Si
No
1st Communion / Primera Comunión
Yes / Si
No
Confirmation / Confirmación
Yes / Si
No
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