Join Parish

Please fill out the form below. The first two fields are the person filling out the form. Required fields have an asterisk mark. Click, "Submit" below to send the information. You will then receive a confirmation email at the email address you provided.

If you have any questions, please contact the Parish Office at (309) 799-3414 or send an email to smg@smgcv.org!

* Required fields
Name *
E-mail Address *
Prefix
First Name *
Last Name *
Marital Status
If Married, was your marriage witnessed by a priest?
Spouse
Maiden Name
Date Married
Number of Children at Home
Will you use church support envelopes?
P.O. Box
Street Address *
Street Address 2
City *
State *
Zip *
Employer
Business Phone
Spouse's Employer
Spouse Business Phone
Languages Spoken
Phone *
Mobile Phone
Spouse Mobile Phone
Highest Education Attained
Highest Education Attained Spouse
Child One's Name
Child One's Sex
Child One Baptized	Yes No Unknown
Child One Penance	Yes No Unknown
Child One First Communion	Yes No Unknown
Child One Confirmation	Yes No Unknown
Child One Handicapped	Yes No
Child One's School
Child One's Grade in School
Child Two's Name
Child Two Sex
Child Two Baptized	Yes No Unknown
Child Two Penance	Yes No Unknown
Child Two First Communion	Yes No Unknown
Child Two Confirmation	Yes No Unknown
Child Two Handicapped	Yes No
Child Two's School
Child Two's Grade in School
Child Three's Name
Child Three's Sex
Child Three Baptized	Yes No Unknown
Child Three Penance	Yes No Unknown
Child Three First Communion	Yes No Unknown
Child Three Confirmation	Yes No Unknown
Child Three Handicapped	Yes No
Child Three's School
Child Three's Grade in School
If you have more than three children, you may enter their information here or call the parish office!
Any Comments
May we include your information in the online directory of Parishoners? *

I have read and agree to the Privacy Policy *

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