Please Print this Page, fill out the form and drop it at St. Mark or mail it to
St. Mark, 1507 S. Vann St., Pryor, OK 74361
Today’s Date:
Primary language spoken at home: ______ English ______ Spanish _____Other
HEAD OF HOUSEHOLD (FULL NAME)___________________________________ Nickname: _____________________ Maiden Name__________________________ Birth date (including year)________________________ Martial Status: ____ Married ____ Single _____ Widowed _____ Divorced Education: _____ HS GRAD ____ College Grad (BS BA M PhD) ______ other specify __________________________________________ Occupation:_____________________________________ Employer: ______________________________________ Employer phone: _______________________________ Baptism Date: mo/day/yr: _______________________ Confirmation Date: mo/day/yr __________________ 1st Holy Communion Date: mo/day/yr_____________ Profession of Faith Date: mo/day/yr _____________________
If Married please complete below: ___ Catholic Place __________________________ City/State ______________________ Date _____/______/_________ By (Priest's Name):________________________________ ___ Non-Catholic ___ Validated in the Catholic Church * Place __________________________________________ Date _____/_____/_________ ___ Civil ___ Validated in the Catholic Church * Place _________________________________________ Date _____/_____/__________