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- I'm New!

Are you new to Kokomo or to St. Patrick?
If so, we want to meet you!

If you would like more information about our parish, please visit our pastorate office or call us at 765-459-4769. If you're ready to register you/ your family as parishioners, please fill out the form below and we will contact you for more information.
The maximum number of form submissions has been reached. This form is currently not available.
- Family Registration
  Please fill out the following information for each member of your household:
- Head(s) of household Please enter valid data.
- Home Address
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  Zipcode Please enter valid data.
- Home phone number Please enter valid data.
- How many people are in your family? REQUIRED Please fill out this field.
  
  Family member 1
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 2
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 3
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 4
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 5
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 6
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 7
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 8
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 9
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
  
  Family member 10
  
  Last name REQUIRED Please fill out this field. Please enter valid data.
  
  First name & Middle Initial Please enter valid data.
  
  Informal Name Please enter valid data.
  
  Maiden name (if applicable) Please enter valid data.
  
  Birthday (MM-DD-YYYY) Please enter valid data.
  
  Gender
  
  Salutation (Mr., Mrs., Miss., etc.) Please enter valid data.
  
  Relationship to you (Husband, Wife, Child., etc.) Please enter valid data.
  
  Religion
  
  Baptized?
  
  Year & Place of Baptism Please enter valid data.
  
  Sacramental Status
  
  Employer or School Please enter valid data.
  
  Occupation or Grade Please enter valid data.
  
  Best individual phone number (please indicate work, cell, etc.) Please enter valid data.
  
  Email address Please enter valid data.
  
  Marital Status
  
  Religious Education
  
  Special needs (if any) Please enter valid data.
- If Heads of Household are married:
  
  Date of Marriage Please enter valid data.
  
  Married with Bishop's Permission
Submit

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Family Registration