St. George Ukrainian Catholic Church
(CONFIDENTIAL – For Church Use Only. All parishioners 18 and older are to be registered)
(Please return completed form to Parish Office 3455 California Ave, Pittsburgh, Pa 15212)
Were you previously registered here? ____ Yes ____ No
Year you moved to this parish: ______
Thank you for registering!
May God grant you many happy and blessed years!
Mailing: (Ms, Miss, Mrs, Mr. Mr. & Mrs.) ______
Telephone No.
Family Name ___________________________________________
Envelope No.
( _____ ) _______ - ____________
Address: _______________________________________________
Email:
#________________________
_________________@________.________
City ___________________________ State _____ Zip ___________
Single Male/Husband
D.O.B.
Marital Status
Occupation:
Bus Phone No.
Marital Status
Occupation:
Bus Phone No.
_____/_____/_____
Single Female/Wife (first & Maiden name)
D.O.B.
_____/_____/_____
D.OB.
Sex
Baptism
Eucharist
Chrismation
1st Confession
School/Occupation
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Children: First & Last Name
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Others in Household + Relationship
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Please indicate interests by family member name:
Music:
Religious Ed:
Cantor _____________________________
Adult Catechesis _______________________________
Chant Group _______________________
Sunday School
Liturgy:
Sunday School Teacher __________________________
Altar Server _________________________
Sunday School Sub/Assistant ______________________
Lector/Reader _______________________
Children Parties/Activities _________________________
Greeter _____________________________
Other _________________________________________
_______________________________
Usher ______________________________
Youth:
Maintenance:
Young Adults __________________________
Church Interior _______________________
Young Retreats ________________________
Cleaning Church ______________________
Young Group __________________________
Hall ________________________________
Other _________________________________
Grass Cutting ________________________
Snow Removal _______________________
Outreach:
Parish Grounds _______________________
Bethany Ministry (Outreach to parishioners) ________________________
Decorating Church (Christmas & Pascha)
____________________
League of Ukrainian Catholics (Eparchial Level )_____________________
Other _______________________________________________________
Other _______________________________
Fundraisers
Parish Committee:
Pyrohy (kitchen or making)_________________________
Parish Advisory Council _____________________
Christmas/Easter Dinner __________________________
Parish Education Board _____________________
Spaghetti Dinner ________________________________
Parish Financial Board ______________________
Christmas/Easter Bread __________________________
Other ____________________________________
Flea Market & Food Festival _______________________
Antique Road Show _____________________________
Lottery Tickets _________________________________
Golf Tournament _______________________________
Other_______________ (name a different fundraiser you wish to be part of)
General Questions:
1. Would you like your name and confinement information published in the parish bulletin in the event of being hospitalized, confined to a nursing
home, or assisted living ________ Yes ________ No
2. Would you like your birthday announced in the parish bulletin? ________ Yes ________ No
3. Do you have any family members, or friends that you would like contacted regarding parish membership? ________ Yes ________ No
Name ________________________ Address _______________________________ Phone No (_____) ______-________
Name ________________________ Address _______________________________ Phone No (_____) ______-________
Name ________________________ Address _______________________________Phone No (_____) ______-_________
4. Would you be willing to provide transportation to and from Church for a parishioner? ________ Yes ________ No