Parish Registration Form

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Name:

First Name

Surname

Email:

Phone Number

Date of Birth :

Place of Birth :

House Name :

Profession

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Spouse :

First Name(If single, mark SINGLE):

Surname

Phone No

Date of Birth :

Place of Birth :

House Name :

Profession

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Child 1:

Name :

Date of Birth :

Place of Birth :

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Child 2 :

Name :

Date of Birth :

Place of Birth :

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Child 3 :

Name :

Date of Birth :

Place of Birth

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Child 4 :

Name :

Date of Birth :

Place of Birth :

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Child: 5

Name

Date of birth

Place of Birth

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Child 6 :

Name

Date of Birth

Place of Birth

Address :

Suburb :

Postcode

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Family Unit (Kudumbakoottayma):

Family Unit:

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Parish Registration Code Number ( Enter the Contribution Number assigned to your family. If none yet - please enter N/A)

Monthly Pledge Status ( Pledged / Would like to make Monthly Pledge - if yes please enter the amount below)

Kerala/India Location details ( Please specify where you/your family are originally from)

Diocese ( Please specify the Diocese you/your family are originally from)

Extra details ( Additional email address, mobile number, comments etc)

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By completing this form, I consent to The St. Marys Syro-Malabar Mission, Sunshine Coast using the provided information responsibly and maintaining confidentiality in accordance with the Eparchy Privacy Policy. (https://syromalabar.org.au/privacy-policy)

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I certify that the information provided in this application form is true to the best of my knowledge and belief and that no information relating to this enrolment application has been omitted

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I agree and authorise St. Mary’s Mission, Sunshine Coast to keep the above information

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I agree for my family members and I to be photographed for Parish Bulletins/ magazines or official website of the parish.

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About us

We welcome you all to be part of our community.

Useful Links

Contact Info

P: +61 408 267 777

E: office.sunshinecoast@syromalabar.org.au

A: 61 Edmund Street, Moffat Beach, QLD 4551, Australia

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