Facebook Phone Email

Parish Registration

Registered in the Parish?
- Interested in registering for the parish or need to updated your information? Click the link on the right to download and fill out the form and return it in the Sunday collection basket or drop it off at the Parish Center or fill out the form below.
- Parish Registration Form
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Head of Household
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last 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.
  
  Primary Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter valid data.
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Additional Household Members REQUIRED Please fill out this field.
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household 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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household Member 13
  
  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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household Member 14
  
  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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Household Member 15
  
  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 Please fill out this field. Please enter a date.
  
  Sacraments Received Baptism Confirmation Holy Communion
  
  Volunteer Opportunities
  
  Liturgy
  
  Parish Activities
  
  Education
  
  Additional Interests or Comments
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
- Parish Registration Form

St. Agatha Catholic Church

Portland, Oregon

Parish Registration

Registered in the Parish?

Parish Registration Form