Saint Dunstan Catholic Church - PARISH REGISTRATION FORM
1133 Broadway Ave, Millbrae, CA 94030
. . .. Tel: (650) 697-4730 - FAX: (650) 697-5203

Date of Application: ___________ / ____ / 200___ .

Sunday Envelopes: Yes__ / No__ . .



Family Name


Telephone Number


Street Address


City

State

Zip Code


Previous Parish


City

State


Husband (First, Middle & Last Name)


Date of Birth


Husband's Church of Baptism


Date of Baptism


Wife (First, Middle & Last Name)


Date of Birth


Wife's Church of Baptism


Date of Baptism


Church of Marriage


Date of Marriage


Single - Head of Household (First, Middle & Last Name)


Date of Birth


Single - Head of Household's Church of Baptism
CHILDREN AND / OR OTHER ADULTS


Date of Baptism


1st Person: (First, Middle & Last Name)


Date of Birth


1st Person's Church of Baptism


Date of Baptism


2nd Person: (First, Middle & Last Name)


Date of Birth


2nd Person's Church of Baptism


Date of Baptism


3rd Person: (First, Middle & Last Name)


Date of Birth


3rd Person's Church of Baptism


Date of Baptism