ST.

WILLIAM CATHOLIC CHURCH

2300 Frederica Road, St. Simons Island, GA 31522 ∙ Phone: 638-2647 Fax: 638-7577

PLEASE PRINT Date _____________

Adult’s Name(s) Religion Birthdate Occupation Home Phone Work Phone Cell Phone
Husband or Single Male Name

Wife or Single Female (Include Maiden Name)

Children’s Names Gender Birthdate Baptized? 1st Communion? Confirmed? Is child attending St.
(living with you) (Yes or No) (Yes or No) (Yes or No) Francis Xavier School?

Local Address City Zip

Mailing Address E-mail Address
Other Addresses If part-time resident,
what months are you here?
Marital Status Single □ Married □ Anniversary Emergency Contact:

Please list your skills, talents and hobbies, that you might AREAS OF INTEREST
like to share.
Altar Server Marian Movement
Choir Primetimers
Council of Catholic Women Religious Education
Centering Prayer St. Francis Xavier School
Coffee & Doughnuts Usher
Eucharistic Minister Lector