Friday, April 14, 2023 at 8:30 AM
Welcome to St. Ann's Catholic Church - DeBary, FL
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Parish Registration Form

Welcome New Member of St. Ann’s:
 
Deciding on a church home is an important step in becoming established in a local community and we are so happy that you are becoming members of this parish community. We hope that you will soon feel comfortable and at home with us and will begin to be involved in parish life.
 
For the last few years St. Ann’s has been experiencing a remarkable period of growth and that growth requires us to rethink our identity as a parish community. Long a primarily retired community, we are now a delightful mix of young and old, married and single, working and retired. Every racial and ethnic group can be found here and we celebrate in the richness of our diversity.
 
Ministries, programs and services spring from the felt needs of our community and we are determined to be a support of presence in the larger community as well.
 
Above all else, we are a community of those who make every effort to be faithful to the call of the Gospel within our Roman Catholic tradition while being open and welcoming to people of every tradition. Our highest priority is our communal worship and prayer and, flowing from that prayer, our efforts to put our faith into concrete action.
 
In the name of our entire parish family I welcome you to St. Ann’s and hope that you will grow and prosper here. I look forward to your becoming rooted and involved here as, together, we seek to be good and faithful disciples of the
Lord Jesus.
 
Sincerely in Christ,
Rev. Andrzej Jurkiewicz
Parochial Administrator
Family Information
Name
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Home Address
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Home Phone --
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List (Multiple Choice)
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Year Arrived at the Parish
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What Mass do you usually attend?
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How do you want to receive Offertory envelopes?
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Winter Resident?
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Preferred method of contact
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Man's Information
Name
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Cell Phone --
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Email
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Title
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Nickname?
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Date of Birth //
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Marital Status
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Date Married //
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Religion
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Baptised?
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First Communion?
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Confirmed?
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Highest Education
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Occupation
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 Indicate if Retired
Business Phone --
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Languages Spoken
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Woman's Information
Name
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Maiden Name
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Cell Phone --
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Email
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Title
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Nickname?
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Date of Birth //
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Marital Status
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Date Married //
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Religion
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Baptised?
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First Communion?
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Confirmed?
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Highest Education
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Occupation
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 Indicate if Retired
Business Phone --
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Languages Spoken
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Child 1 Information
Name
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Nickname?
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Gender
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Date of Birth //
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Baptised?
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First Communion?
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Confirmed?
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Highest Education (to date)
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Languages Spoken
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Child 2 Information
Name
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Nickname?
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Gender
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Date of Birth //
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Baptised?
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First Communion?
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Confirmed?
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Highest Education (to date)
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Languages Spoken
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Child 3 Information
Name
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Nickname?
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Gender
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Date of Birth //
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Baptised?
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Confirmed?
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First Communion?
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Highest Education (to date)
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Languages Spoken
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Other Adult Information
Relationship
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Name
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Maiden Name (if appropriate)
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Cell Phone --
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Email
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Title
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Nickname?
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Gender
  •  
Date of Birth //
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Marital Status
  •  
Date Married //
  •  
  •  
Religion
  •  
Baptised?
  •  
First Communion?
  •  
Confirmed?
  •  
Highest Education
  •  
Occupation
  •  
 Indicate if Retired
Business Phone --
  •  
Languages Spoken
  •  
  •  
 
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