Registering as a Parishioner

- Contact

All Catholics living in the area and regularly worshipping at the Basilica should register as parishioners. Children of registered parents must re-register as adults on their 18th birthday. Formal registration is required for persons wishing to participate in any sacramental preparation. Parish membership enables us to mutually turn to each other for support and service.

You can register by completeting the online form below. If that is not possible, you may download the Basilica Parish Registration Form below and send it in to the pairsh office.

Please call the parish office for assisstance. There is also an opportunity to register as a parishioner at the monthly Meet & Greet on the first Sunday of every month.
Registration Form
- Basilica Parish Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Family Information
  
  Family Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Home Phone Number Please enter a phone number.
- Number of Family Members REQUIRED Please fill out this field.
  
  Individual 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
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
  
  Individual 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.
  
  Title
  
  Maiden Name Please enter valid data.
  
  Preferred Name Please enter valid data.
  
  Family Relationship
  
  If other... Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Marital Status
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Religious Denomination Please enter valid data.
  
  Ethnic Background Please enter valid data.
  
  Language(s) English Polish Spanish Other
  
  If other... Please enter valid data.
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Cellular Number Please enter a phone number.
  
  Work Number Please enter a phone number.
  
  Email Address Please enter an email address.
  
  Highest Level of Education Please enter valid data.
  
  List degrees, licenses, and/or certificates Please enter valid data.
  
  Are you an Alumnus of Saint Josaphat Parish School Yes No
  
  If yes, what year did you graduate? Please enter an integer (number).
  
  Sacramental Information
  
  Baptism REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  First Communion REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Marriage (By a Priest?) REQUIRED Yes No Please fill out this field.
  
  Approximate Date Please enter a date.
  
  Church & City/State Please enter valid data.
  
  Activites
  
  (Please use this sheet to select the appropriate codes; complete for each member age 5 and older)
  
  Talents
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Current Parish Involvement
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Groups interested in being involved
  Please separate codes by slashes
  Please enter valid data.
  
  Other Please enter valid data.
  
  Additional Information
  
  Are you home bound? Yes No
  
  Do you need to receive Communion at home? Yes No
  
  Do you reside in a nursing home? Yes No
  
  If yes, please provide the name and the address of the nursing home below
  
  Do you have any special needs or impairments? Yes No
  
  If yes, please describe
Submit

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Contact Us
- Mrs. Carrie Nolder
  
  Parish Secretary
  
  (414) 645-5623 ext. 210
  sjbdomethebasilica.org