Rectory - 641 Thiele Road, Brick, NJ 08724

Phone: (732) 458-0220 ~ Fax: (732) 458-0855

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Online Parish Registration

If you prefer not to register online, you may download a copy of the Registration Form here.  Otherwise submit the online form below.  Please take your time and fill in all appropriate fields - this will help us to keep our records up to date.
(Required fields are marked with an asterisk)
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Family Information

Today's Date (mm/dd/yyyy) *
Parish of Last Registration
Last Name *
First Name *
Spouse
Salutation
Address
Home Phone *
City
Family Email Address
Zip Code
Marital Status
Marriage (Date, Place, Name of Parish
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First Family Member

Salutation/Title *
Name (First, Last/Maiden) *
Member Type *
Gender
Male
Female
Date of Birth (mm/dd/yyyy) *
Cell Phone
Work Phone
Email Address
Sacraments Received
Baptism
Penance
First Communion
Confirmation
Religion *
Occupation
Handicap/Disabilities
Highest Grade/Degree
Add Another Adult living at Home
Yes
No
Employer
Languages Spoken
School Attending
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Additional Adult/Spouse

Salutation/Title *
Member Type *
Name (First, Last/Maiden) *
Date of Birth (mm/dd/yyyy) *
Gender
Male
Female
Cell Phone
Work Phone
Email Address
Status
Sacraments Received
Baptism
Penance
First Communion
Confirmation
Religion *
Occupation
Handicap/Disabilities
Highest Grade of Degree
Employer
Languages Spoken
School Attending
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Children Living at Home

FIRST CHILD: Full Name
School
Grade
Gender
M
F
Date of Birth (mm/dd/yyyy)
Cell Phone
Email Address
Sacraments Received
Baptism
Penance
First Communion
Confirmation
SECOND CHILD: Full Name
School
Grade
Gender
M
F
Date of Birth (mm/dd/yyyy)
Cell Phone
Email Address
Sacraments Received
Baptism
Penance
First Communion
Confirmation
THIRD CHILD: Full Name
School
Grade
Gender
M
F
Date of Birth (mm/dd/yyyy)
Cell Phone
Email Address
Sacraments Received
Baptism
Penance
First Communion
Confirmation
FOURTH CHILD: Full Name
School
Grade
Gender
M
F
Date of Birth (mm/dd/yyyy)
Cell Phone
Email Address
Sacraments Received
Baptism
Penance
First Communion
Confirmation
Submit
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CHURCH OF EPIPHANY

church midsize615 Thiele Road, Brick, NJ 08724
Phone: (732) 458-0220 ~ Fax: (732) 458-0855

DIRECTIONS TO OUR PARISH