Registration Form

Registration Form

Emmaus Catholic Church
1718 Lohman's Crossing Road
Lakeway , TX 78734
(512) 261-8500
Fax (512) 261-8200
emmaus@emmauslakeway.com
www.emmauslakeway.com

THANK YOU FOR UPDATING YOUR INFORMATION
Please UPDATE any fields that have changed since your original Registration.
Confidentiality prevents us from displaying the information in your current record. If you are in doubt about whether any of the fields have been previously completed or changed please enter the data anyway so that we may be sure to have the correct information to better serve you.
This information is strictly confidential, for pastoral use only, and will not be given out to unauthorized personnel.

Items in RED are required for the form to be successfully submitted

	Last Name/Apellido	First Name/Nombre	Preferred Name/Nombre preferido	Gender ( M or F )
Self
Spouse

Address/Domicilio Zip/Código postal

Mailing Address (if different from above)

Phone Is number listed? ( Y or N )

Title: Specify Marital Status:

SELF/YO

Religion/ Religión	Date of Birth ( mm/dd/yyyy )/ Fecha de Nacimiento	2nd Language/ Segunda Idioma

Occupation/ Ocupación/Profesión	Employer/ Patrón,-a

Work Phone/ Teléfono, trabajo	Cell Phone/ celular	email/ Correo electrónico

Life Experience or Skills/
Habilidad o experiencias en tu vida

SPOUSE/ESPOSA, -O

Religion/ Religión	Date of Birth ( mm/dd/yyyy )/ Fecha de Nacimiento	2nd Language/ Segunda Idioma

Occupation/ Ocupación/Profesión	Employer/ Patrón,-a

Work Phone/ Teléfono, trabajo	Cell Phone/ celular	email/ Correo electrónico

Life Experience or Skills/
Habilidad o experiencias en tu vida

CHILDREN UNDER 18/HIJOS MENOS DE 18 AÑOS
- Any children over 18 should be registered separately

					( Sacrament received ? Y or N )/ (Sacramentos cumplídos Y/N)
Name/Nombre	Gender	Birth Date mm/dd/yyyy	Grade	School/Escuela	Baptism	Communion	Reconcilliation	Confirmation

Comments or Additional Information