Become a Member

- Welcoming all to grow in faith, love, and service.
  
  Belonging to a community can enhance our lives in numerous ways and help us to grow in our faith. To be a Catholic means to have a special relationship with God and with other people. As a registered parishioner, you will be an active member of our Jesus the Good Shepherd community!
  
  The parish strives to serve the parish community through our sacramental, ministerial and educational programs. In order to do so, the parish requires accurate parishioner information. Please fill out the form below to become a member, or update information.
Parish Enrollment | Existing Member Changes
- The maximum number of form submissions has been reached. This form is currently not available.
  
  If you would like to join our parish or update your information in our system, please fill out the following online form.
  
  Date Submitted REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Parishioner Status REQUIRED Please fill out this field.
  
  Family Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Are you registered at another church? REQUIRED Yes No Please fill out this field.
  
  If yes, where? Please enter valid data.
  
  Primary Residence
  
  Primary 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Confirm Email REQUIRED Please fill out this field. Please enter an email address.
  
  Preferred Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Head of Household
  
  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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Phone Number Maximum 20 characters
  If different from above!
  Please enter a phone number.
  
  If different from above.
  
  Education Completed
  
  Employment Status
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Religious Denomination REQUIRED Please fill out this field.
  
  Baptized REQUIRED Yes No Please fill out this field.
  
  Communion REQUIRED Yes No Please fill out this field.
  
  Confirmation REQUIRED Yes No Please fill out this field.
  
  Convert REQUIRED Yes No Please fill out this field.
  
  Are you interested in becoming Catholic? Yes No
  
  Marital Status
  
  Date Married Please enter a date.
  
  Date (Separated, Divorced, Anulled)
  MM/DD/YYYY
  Please enter a date.
  
  Were you married by a Priest? Yes No
  
  If yes, Where/What Parish? Please enter valid data.
  
  Spouse (If applicable)
  
  Title
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Date of Birth
  MM/DD/YYYY
  Please enter a date.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Education Completed
  
  Employment Status
  
  Occupation Please enter valid data.
  
  Employer Please enter valid data.
  
  Religious Denomination
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmation Yes No
  
  Convert Yes No
  
  Are you interested in becoming Catholic? Yes No
  
  Other Family Members (if applicable)
  
  Number of Additional Family Members Please fill out this field.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Employer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 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.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Family Member 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED
  MM/DD/YYYY
  Please fill out this field. Please enter a date.
  
  Baptized Yes No
  
  Communion Yes No
  
  Confirmed Yes No
  
  Present Emlpoyer Please enter valid data.
  
  Present School & Grade Please enter valid data.
  
  JGS Elementary School Graduation Year Please enter valid data.
  
  Continued..
  
  Languages spoken at home: Please enter valid data.
  
  Is anyone homebound? Yes No
  
  Please list if anyone in your household serves on a Parish Committee or Ministry:
  
  I have a particular talent, hobby, or professional service I would like to offer:
  
  I/we will support the Parish with a monetary gift, either: Automatic online weekly or monthly deduction Weekly, using envelopes returned at Weekend Mass
  
  If you would like to sign up for automatic online giving, visit our 'Give' tab on the home page.
  
  Emergency Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters
  Adult child or parent living outside this residence.
  Please fill out this field. Please enter a phone number.
  
  Submit
  
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