Registration Form

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.

Address 2 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.

Phone Number REQUIRED

Please specify home phone or mobile

Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Please enter valid data.

Occupation Please enter valid data.

Spouse's name Please enter valid data.

Spouse Phone Number

Please specify home phone or mobile

Please enter a phone number.

Spouse Email Please enter an email address.

Spouse Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender Please enter valid data.

Occupation Please enter valid data.

Please tell us about your family. Include full name, religion, date of birth and gender of each person you wish to register.

Extended Family Living in Household

Language/Ethnicity of Family Members (optional) Please enter valid data.

Special Needs

2. Does anyone in your household have any special requirements, disabilities, or is anyone homebound?

Would you like to be part of one or more of our ministries?

Christian Formation RCIA Lay Augustinians ChristLife / Discovering Christ Parish Religious Education Program (PREP)

Pastoral Care Nursing Home Volunteers Helping Other People in Emergencies (HOPE)

Spirituality ChristLife (Discovering Christ, etc.) Faith Sharing Group Spiritual Reading Group Augustinian Spirituality Group

Social Justice Interfaith Hospitality Network (IHN) Peace & Justice Committee

Youth Catholic Youth Organization (CYO Sports) Youth Group (Middle and High School Students) PREP (Parish Religious Education Program: K to 6)

YES, I want to help provide support for the parish. Please enroll me for: REQUIRED Contribution Envelopes Parish Giving (electronic) Please fill out this field.

Do you have any questions or concerns that we may answer at this time?

Our Mother of
Good Counsel

Catholic Parish || Bryn Mawr, PA

Registration Form