Parish Registration Form

Surname (required)

First name (required)

Other names (required)

MaleFemale

State of Origin
Non-NigerianAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCrossDeltaEbonyiEdoEkitiEnuguFCTGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfara

Date of Birth

Marital Status ---MarriedSingleOther

Date of Marriage (if Married)

Name of Spouse (if married)

Names of Children (if any) and Date of Birth

Home Address

Your Email (required)

Mobile Phone Number

Please indicate sacraments received
BaptismEucharistConfirmationMatrimony

Please include your social media details below

Facebook

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WhatsApp

Statutory Bodies and Societies you belong to
CMOCWOCYONLegion of MaryBoard of LectorsChoirOthers

Other Statutory Bodies and Societies not listed above

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