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  Site Last Updated: September 19, 2017
3310 Jefferson Highway, Lousiana 70121 | Phone:(504)-833-3366/ 833-4118 | Fax:(504)-834-1532

Family Registration Form

When you submit this form, all of the information will be sent by e-mail to St. Agnes Parish.


* Required fields
Head of Household
Title * First Name * Last Name Suffix
Birth Date:   * Gender:  Female  Male

Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
Spouse
Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male

Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
Address
* Line 1
   Line 2
* City
* State
* ZIP
   E-Mail
Send E-Mail Instead of Mail When Possible
Phone
* Primary ( ) - Unlisted
   Other ( ) - Unlisted
 

Member 1 - Type

Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
 

Member 2 - Type

Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
 

Member 3 - Type

Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
 

Member 4 - Type

Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage
 

Member 5 - Type

Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Sacraments Rcv      Date
Baptism
First Comm
Confirm
Marriage

When you submit this form, all of the information will be sent by e-mail to St. Agnes Parish.