Please complete the following form to register in
The Church of St. Timothy.

When you have completed the form please click "Submit Form".

Thank You

If you have any questions please call (760)-489-1242 or email the church.

Please complete all the information that you can. An incomplete form will have to be mailed to you for completion.

 

* Family Name * Date (dd/mm/yy)
* Address Apt#
* City
* Zip Code * State
* Home Phone
Work Phone - Husband's Wife's Head of Household
Wife's Maiden Name
Email Address
 
* Marital Status
In Catholic Church
Outside Catholic Church
Divorced
Separated
Widowed
Single
Select Only 1
Please Replace The Default "First Name" Boxes Below With Your Information Where Necessary
List Only Those Living With You
Date of Birth
(dd/mm/yyyy)
Country
of
Birth
Religion
Baptism
First Confession
First Communion
Confirmation
Occupation/ School
Grade

Single

Husband
Wife
Children
Please enter all the information you can.
Others that live with you

Please enter any additional information you believe is relevant


05/19/2004