Welcome to Historic Saint Patrick Church. We look forward to having you as part of our
 faith community. If you have any questions about this process, please contact our office at
 309-829-1355

Click Submit Form to send this information to St. Patrick's Parish.

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*Registration Option Register a New Family Update an Existing Family *ID/Env:  
Head of Household
Title *First Name *Last Name Suffix
Relationship   Middle Name   Nickname Maiden Name
Ethnicity *Birth Date *Gender Female   Male
Grade/Degree   Language *Marital Status
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1   Unlisted
Send Email Instead of Mail When Possible
  Email 2   Unlisted
Send Email Instead of Mail When Possible
Sacraments   Name Received Date Place
   Baptism
   Confirmation
   Marriage
Spouse
Title   First Name   Last Name Suffix
Relationship   Middle Name   Nickname Maiden Name
Ethnicity   Birth Date   Gender Female   Male
Grade/Degree   Language Marital Status
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1   Unlisted
Send Email Instead of Mail When Possible
  Email 2   Unlisted
Send Email Instead of Mail When Possible
Sacraments   Name Received Date Place
   Baptism
   Confirmation
   Marriage
Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP
Family Mailing Address
  Line 1
  Line 2
  City
  State
  ZIP
Family Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Email
*Email   Unlisted
Send Email Instead of Mail When Possible
Member 1   Type  
Title   First Name   Last Name Suffix
Relationship   Middle Name   Nickname Maiden Name
Ethnicity   Birth Date *Gender Female   Male
Grade/Degree   Language *Marital Status
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1   Unlisted
Send Email Instead of Mail When Possible
  Email 2   Unlisted
Send Email Instead of Mail When Possible
Sacraments   Name Received Date Place
   Baptism
   Confirmation
   Marriage

Click Submit Form to send this information to St. Patrick's Parish.

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