Parish Registration

SJERC Parish Registration Form

  • Date Format: MM slash DD slash YYYY
  • Household Information

  • Date Format: MM slash DD slash YYYY
  • Male Head of Household / Husband

  • Date Format: MM slash DD slash YYYY
  • Female Head of Household / Wife

  • Date Format: MM slash DD slash YYYY
  • Children in Household

    Please complete for each individual child and send an email to Cynthia.Herrera@sjerc.org if more than four children need to be enrolled.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY