Registration Form 407 S. 33rd Street Fort Pierce, FL Fax

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Registration Form 407 S. 33rd Street Fort Pierce, FL 34947 772-461-2233 Fax 772-461-2242 www.stanastasiachurch.org

Welcome to St. Anastasia Catholic Church! Upon your completion of the registration form for St. Anastasia, our office will properly record your personal data and sacramental records in our database. Please keep in mind it is very difficult for any administration to identify a family as officially registered, when there is no official record or data on a family. As a registered parishioner of St. Anastasia Catholic Church, the church can better assist you and your family in matters regarding: sacramental record keeping, wedding preparation, completion of sacraments, funeral arrangements, sick calls, homebound or hospital outreach opportunities, taxable donation relief, and much more. As a registered family the church will have a history of your family s stewardship regarding time, talent, and treasure. For those parents seeking school tuition subsidy support: When your family is registered at a church other than St. Anastasia and you would like to officially register with us, you will need a letter signed by the Pastor of the church you are leaving. That signed letter must accompany this registration form. Additionally, in order to begin to qualify for subsidy support from St. Anastasia Church, you and your family must have at least one full year of ministry involvement and uninterrupted tithing for 12 consecutive months with our church. As you review your options for tithing, the church highly encourages you to sign up for online giving through Faith Direct. If you are a new parishioner with a possible interest to qualify for parish subsidy support, Faith Direct is a requirement. All tithing should reflect your prayerful discernment of giving back to God. Tithing also reflects the commitment your family has to the church. Thank you for taking the time to read through the above information. As Pastor, Shepherd, and Father of St. Anastasia Catholic Church and School, I welcome you to our parish family. Monday- Saturday - Daily Adoration 7:45am followed by Mass at 8:15am. Confession Saturday at 3:00pm

(Please print clearly in ink) Today s : Registration Form St. Anastasia Catholic Church 407 S. 33rd Street Fort Pierce, FL 34947 www.stanastasiachurch.org Family Name: Office Use Only: ENV PDS WEL MIN CC Primary Home Phone # Marital Status (M,S,W,D): First Name: Cell: DOB Spouse Name: Cell: DOB Your Occupation: Spouse Occupation: Local Address: Alternate Address: Mailing Address: First Middle Last of Birth School Name M or F First Middle Last of Birth School Name M or F First Middle Last of Birth School Name M or F First Middle Last of Birth School Name M or F Do you wish to receive correspondence from St. Anastasia via email? Yes No Email Address: Name Email Address: Name We offer online giving at www.faithdirect.net (Parish Code FL661) it s convenient, saves time and save the parish cost of envelopes and postage. Please select Envelopes Online Giving (onsite assistance available) Are you a full time resident? Yes No If no, months at local residence / from to How long have you (or your family) been attending St. Anastasia Church? Do you need assistance getting your marriage blessed? Would you like to explore avenues surrounding an annulment? Yes No Are you or your children in need of any sacraments?

Parish Ministries & Organizations Currently Involved Interested in Joining Altar Server Ministry Bereavement Ministry Bingo Catholic Young Adults Children s Liturgy Ministry Children s Nursery Ministry Eucharistic Ministry Friends & Family Fellowship Ministry Knights of Columbus Lector Ministry Media Ministry Music Ministry Perpetual Eucharistic Adoration Prison Ministry Respect Life Ministry S.A.M.M. (Social Awareness and Action Ministry) Sacramental Outreach Ministry Street Evangelization Ministry Theatre Ministry Ushering Ministry Youth Group (Middle School) Welcome Ministry

Household Member Info Primary Spouse Child Child Child First Name Last Name Religion Sacraments Received (Check all that Apply) Baptism First Communion Confirmation Marriage N/A N/A N/A Wife s Maiden Name Church City/State Catholic/ Non-Catholic/Civil