Mary, Queen of Peace Catholic Church

Mary, Queen of Peace
Catholic Church

l 7738 Barksdale Blvd l Bossier City, LA 71112 l
l Telephone: (318) 752-5971 l FAX: (318) 752-5973 l

Registration

l To have the church office contact you please fill in the form below l

Mr., Mrs., Miss, Ms, Rank, Title
First Name
Middle Name
Last Name
Your Date of Birth
Your Religion
Date of Your Baptism
Date of Your First Communion
Date of Your Confirmation
Your Years of Education
Marital Status: Married, Single, Divorced, Separated, Widowed
Married by whom: Priest, Minister, etc.
Date of Marriage
Spouse's First Name
Spouse's Middle Name
Spouse's Last Name
Spouse's Date of Birth
Spouse's Religion
Spouse's Date of Baptism
Spouse's Date of First communion
Spouse's Years of Education
Spouse's Date of Confirmation
Address Line 1
Address Line 2
City
State
Zip Code
Daytime Phone	() -
Evening Phone	() -
E-mail Address
For child #1 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #2 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #3 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #4 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #5 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #6 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
For child #7 please list full name, dob, religion, dates of baptism, first communion, confirmation, and years of education.
Please list all family church interests: Extraordinary Minister of Holy Communion, Lector, Usher, Altar Server, P.S.R., Youth Group, RCIA, Choir, Children's Liturgy, Bereavement Group, Hospital/Nursing Home/Hospice Ministry, Building & Maintanence, Liturgy & Worship, Socials, Ladies' Guild, Parish Life, Social Concerns, St. Vincent de Paul, Knights of Columbus, Teaching, Clerical, Domestic or skilled help/ Catholic Daughters, Immaculate Conceptiion, etc.
What is a good time for your appointment with our pastor?
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