Welcome to Historic Saint Patrick Church. We are delighted you have chosen to become
 a registered member of our 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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*Required fields

*Registration Option Register a New Family Update an Existing Family *ID/Env:  
       Note: Just enter the field(s) that need to be updated.

Head of Household
Title *First Name *Last Name Suffix
  Middle Name   Nickname Maiden Name
  Birth Date *Gender Female   Male
  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
   Baptism
   Confirm
   Marriage

Spouse
Title   First Name   Last Name Suffix
  Middle Name   Nickname Maiden Name
Ethnicity   Birth Date   Gender Female   Male
  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
   Baptism
   Confirm
   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
Family Email Address
*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
   Baptism
   Confirm
   Marriage


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