Home - St. Bernard's Roman Catholic Church - Strong roots, new growth... Building our future   Moncton, New Brunswick Canada
Parish Registration Form
What name should be on the income tax receipt?  
Date: Mass normally attending: 4:00 PM 11:00 AM

Please choose one: Mr. Mrs. Ms.

First Name: Date of Birth:
Last Name: Maiden Name:
(if applicable)
Address: City:
Province: Postal Code:
Phone (Home): Phone (Bus.):
E-mail: Fax:
Civil Status: Married Single Widowed Separated Divorced  

Spouse's First Name: Date of Birth:
Spouse's Last Name: Maiden Name:
(if applicable)
Spouse's Occupation: Business Phone:
Religious Denomination of Spouse:

Names of children under 18 years (over 18, please complete own form)
Name Date of Birth (YYYY/MM/DD) Baptized (Where and when?)

Do you currently contribute to the church through the use of parish envelopes?
Yes No
If No, do you wish to begin recieving parish envelopes?
Yes No
Do you attend a weekend mass at another church in the Greater Moncton area on an average of once a month or more?
Yes No
Previous parish?

  Past Present Interested Which Family Member?
Youth Ministry
Vocations Committee
Chair Lift
Communion Minister
Altar Server
Pastoral Care to the Sick and Shut-in
Parish Council
Marriage Preparation
Baptismal Preparation
Funeral Team
Catholic Women's League
Knights of Columbus
Other suggestions

If there is some way in which you would like to serve your parish community that is not being addressed here, please indicate your area of interest:
Other comments / concerns / suggestions:

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