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Online Registration

- About Us
  - WELCOME
    
    From the Pastor
    New Parishioners
    
    Online Registration
  - WHO WE ARE
    
    Mission / Vision
    Clergy & Parish Staff
    Patron Saint
    Parish History
  - INFORMATION
    
    Mass Times
    Contact Us
    Directions
  - INTENTIONS
    
    Mass Intentions
    Prayer Request
    Prayer for the Sick
    Pray for Vocations
  - Advent 2023

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- City REQUIRED Please fill out this field. Please enter valid data.
  
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  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone: Please enter valid data.
- Cell Phone: REQUIRED Please fill out this field. Please enter valid data.
- Email Address REQUIRED Please fill out this field. Please enter valid data.
- Household Member (Adult) REQUIRED Please fill out this field.
  
  Member 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Nickname Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field. Please enter valid data.
  
  Language REQUIRED Please fill out this field. Please enter valid data.
  
  Special Needs REQUIRED Please fill out this field.
  
  Education (High School or College Level Reached / Degree attained)
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Baptized REQUIRED Please fill out this field.
  
  First Communion REQUIRED Please fill out this field.
  
  Confirmed REQUIRED Please fill out this field.
  
  Marital Status REQUIRED Please fill out this field.
  
  Member 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Nickname Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field. Please enter valid data.
  
  Language REQUIRED Please fill out this field. Please enter valid data.
  
  Special Needs REQUIRED Please fill out this field.
  
  Education (High School or College Level Reached / Degree attained)
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Baptized REQUIRED Please fill out this field.
  
  First Communion REQUIRED Please fill out this field.
  
  Confirmed REQUIRED Please fill out this field.
  
  Marital Status REQUIRED Please fill out this field.
- If married, please provide the following information:
- Marriage Date: Please enter valid data.
- Location: Please enter valid data.
- Married in a Catholic Church?
- Children REQUIRED
  Please fill out for any children living in your household under the age of 18
  Please fill out this field.
  
  Child 1
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child 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.
  
  Gender: REQUIRED Please fill out this field.
  
  Birthdate: REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade: REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance REQUIRED Please fill out this field.
  
  First Holy Communion REQUIRED Please fill out this field.
  
  Confirmation REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
- Others at Home REQUIRED
  Please provide this information for any children who are no longer minors or any other adults living in the household
  Please fill out this field.
  
  Member 1
  
  Name (Relationship) Please enter valid data.
  
  Gender
  
  Birthdate: Please enter valid data.
  
  Baptism Date: Please enter valid data.
  
  Attending College?
  
  First Penance
  
  First Communion
  
  Confirmation
  
  School Attending Please enter valid data.
  
  Member 2
  
  Name (Relationship) Please enter valid data.
  
  Gender
  
  Birthdate: Please enter valid data.
  
  Baptism Date: Please enter valid data.
  
  Attending College?
  
  First Penance
  
  First Communion
  
  Confirmation
  
  School Attending Please enter valid data.
  
  Member 3
  
  Name (Relationship) Please enter valid data.
  
  Gender
  
  Birthdate: Please enter valid data.
  
  Baptism Date: Please enter valid data.
  
  Attending College?
  
  First Penance
  
  First Communion
  
  Confirmation
  
  School Attending Please enter valid data.
  
  Member 4
  
  Name (Relationship) Please enter valid data.
  
  Gender
  
  Birthdate: Please enter valid data.
  
  Baptism Date: Please enter valid data.
  
  Attending College?
  
  First Penance
  
  First Communion
  
  Confirmation
  
  School Attending Please enter valid data.
  
  Member 5
  
  Name (Relationship) Please enter valid data.
  
  Gender
  
  Birthdate: Please enter valid data.
  
  Baptism Date: Please enter valid data.
  
  Attending College?
  
  First Penance
  
  First Communion
  
  Confirmation
  
  School Attending Please enter valid data.
- Stewardship of Treasure:
- Would you like collection envelopes mailed to you? REQUIRED Please fill out this field.
- If yes to the above, how frequently? Weekly Monthly
- For your convenience, St. Benilde Catholic Church now offers Electronic Giving. If you prefer to give online (instead of using the weekly or monthly envelopes) you can register for E-Giving on our parish website.
  
  E-Giving
- Are you a registered parishioner in another territorial parish? REQUIRED Please fill out this field.
- Name of Parish: Please enter valid data.
- How long? Please enter valid data.
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