Saint Francis of Assisi Church
5265 Placida Road
Grove City, FL 34224
Confidential Parish Information
Family Last Name
Physical Address (Street Address/City/State/Zip)
Mobile Home Park or Subdivision Name (if applicable)
Mailing Address (if different from above)
Residency?
Full-Time Resident? Part-time Resident? If part-time, months in Florida each calendar year? ____ Home Phone (Landline)
Cell Phone
Family Email Address
Name and Place of Previous Parish
Language Spoken in the Home
Would you like to receive contribution envelopes? Envelope #__________ (to be completed by Parish Office)
Yes (if selecting yes, please pick up your envelopes at the Parish Office) No Would you like to participate in our Online Giving program? If selecting "Yes", you can visit our Online Giving Website at https://sfoachurch.weshareonline.org/
Yes No Would you like to schedule an appointment to meet with the pastor?
Yes No Head of Household Full Name (First Middle Last)
Maiden Name (if applicable)
Marital Status
Single Married Widow(er) Separated Divorced Gender
Male Female Date of Birth (MM/DD/YYYY)
Religion
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Mass Attendance
Weekly Monthly Seldom Special Needs?
Occupation (if retired, previous occupation)
Place of Employment
If there are no other members, please scroll to bottom of form to submit. Otherwise, please continue.
Spouse Full Name (First Middle Last)
Maiden Name (if applicable)
Marital Status
Single Married Widowed Divorced Separated Gender
Male Female Date of Birth (MM/DD/YYYY)
Religion
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Mass Attendance
Always Frequently Seldom Never Occupation (if retired, previous occupation)
Place of Employment
Special Needs?
If there are no other members, please scroll to bottom of form to submit. Otherwise, please continue.
Child/Dependent 1 Full Name (First Middle Last)
Gender
Male Female Date of Birth (MM/DD/YYYY)
Relationship to Head of Household
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Attends Mass regularly?
Yes No Occupation
School
Grade
Special Needs?
If there are no other members, please scroll to bottom of form to submit. Otherwise, please continue.
Child/Dependent 2 Full Name (First Middle Last)
Gender
Male Female Date of Birth (MM/DD/YYYY)
Relationship to Head of Household
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Attend Mass regularly?
Yes No Occupation
School
Grade
Special Needs?
If there are no other members, please scroll to bottom of form to submit. Otherwise, please continue.
Child/Dependent 3 Full Name (First Middle Last)
Gender
Male Female Date of Birth (MM/DD/YYYY)
Relationship to Head of Household
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Attends Mass regularly?
Yes No Occupation
School
Grade
Special Needs?
If there are no other members, please scroll to bottom of form to submit. Otherwise, please continue.
Child/Dependent 4 Full Name (First Middle Last)
Gender
Male Female Date of Birth (MM/DD/YYYY)
Relationship to Head of Household
Baptized?
Yes No Received First Holy Communion?
Yes No Confirmed?
Yes No Attends Mass regularly?
Yes No Occupation
School
Grade
Special Needs?
If there are additional members of your family, please submit this form and open a new form. Simply enter the family name and the word "Continued." Then scroll down to "Child/Dependent 1" and complete information about the additional members. Then submit.
If you are interested in volunteering in one of the many available ministries here at Saint Francis of Assisi, select the link below (or copy and paste to your web browser) to complete the Volunteer INFORMATION Request Form. Completing this form does not commit you to anything, but gives us the opportunity to provide you more information.
http://www.sfoachurch.com/volu