St. Jane Frances de Chantal
Catholic Church
(Pastorate parish with OLC)

8499 Virginia Ave.
Riviera Beach, Maryland 21122

www.stjane.org

www.stjane.org

Facebook Flocknote Phone

Parish Registration Form

- Home

Welcome to St. Jane Frances Parish! We are glad you are apart of our Parish community!
The maximum number of form submissions has been reached. This form is currently not available.
- Household Contact Information
  (Enter information below for an adult in this household (over 21 or married person)
- Title REQUIRED Please fill out this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name: REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name (if female) REQUIRED Please fill out this field. Please enter valid data.
- Suffix
- Date of Birth: (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
- Place of Birth: REQUIRED Please fill out this field. Please enter valid data.
- Marital Status: REQUIRED Please fill out this field.
- Occupation REQUIRED Please fill out this field. Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- If Married, then when is your Anniversary? (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
- Home Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Are you tranferring from another parish within the Archdiocese of Baltimore? REQUIRED Please fill out this field.
- How would you like to make a contribution to St. Jane Frances? REQUIRED Please fill out this field.
- Would you like to receive the Catholic Review Magazine? REQUIRED Please fill out this field.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Head of House #2
  (Enter information below for an adult in this household (over 21 or married person)
- Title
- Suffix
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Name: Please enter valid data.
- Maiden Name (if female) Please enter valid data.
- Email Please enter an email address.
- Cell Phone Maximum 20 characters Please enter a phone number.
- Date of Birth: (mm/dd/yyyy) Please enter valid data.
- Place of Birth: Please enter valid data.
- Occupation Please enter valid data.
- Religion Please enter valid data.
- Marital Status:
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
- Family Member #3
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Name: Please enter valid data.
- Suffix
- Gender
- Relation to Head of Household:
- If other, please explain: Please enter valid data.
- Date of Birth: (mm/dd/yyyy) Please enter valid data.
- Place of Birth: Please enter valid data.
- Religion: Please enter valid data.
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
- FAMILY MEMBER #4
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Name: Please enter valid data.
- Suffix
- Gender
- Relation to Head of Household:
- If other, please explain: Please enter valid data.
- Date of Birth: Please enter valid data.
- Place of Birth: Please enter valid data.
- Religion: Please enter valid data.
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
- FAMILY MEMBER #5
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Initial: Please enter valid data.
- Suffix
- Relation to Head of Household:
- If other, please explain: Please enter valid data.
- Date of Birth: Please enter valid data.
- Place of Birth: Please enter valid data.
- Religion: Please enter valid data.
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
- FAMILY MEMBER #6
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Initial: Please enter valid data.
- Suffix
- Relation to Head of Household:
- If other, please explain: Please enter valid data.
- Date of Birth: Please enter valid data.
- Place of Birth: Please enter valid data.
- Religion: Please enter valid data.
- Sacraments Received: Baptism 1st Communion Reconciliation Confirmation
Submit