Please give us the opportunity to be of service to you and help us to become acquainted with you by printing and filling in this page. Please drop it off a the Parish Offices, 5 Fatima Drive, Riverview, weekdays from 9 to 5, or put it in the collection basket at any of the churches.

To submit the form online, please copy and paste it into a ‘new message’ in your email program, then add in your information and send it on to the following email address:

Which of our 4 churches do you attend:

( ) Immaculate Heart of Mary Church ( )Saint Jude’s Church

Family Name: __________________ First Name: _________________ Religion ______

Spouse: ____________________ Religion ______ Maiden Name: ___________________

Address: ____________________________________________________________

Postal Code: ___________ Phone No. ____________ E-mail: __________________

Marital Status: ___________________________

Children’s Name Date of Birth

__________________________ _______________.

__________________________ _______________.

__________________________ _______________.

Do you wish contribution envelopes? ____ .Automatic withdrawal? ___.

Would you like to become involved in parish ministry or groups? ________.

Would you like to meet with a staff member? _____.