Church of St. Francis Xavier

Church of St. Francis Xavier
223 19th St NW ~ Buffalo, Minnesota 55313
Welcome to St. Francis Xavier Parish!
Enclosed is a registration form to be filled out and returned to us as soon as
possible. You may drop it off or mail it to the Parish Office, Church of St. Francis
Xavier, 223 19th St NW, Buffalo, MN 55313. You may also email it to
[email protected]. All information provided on this form will be treated
confidentially and will only be used by St. Francis Xavier Catholic Church. None of
the data will be distributed to any outside group or sold for mailing lists.
If you have any questions, please don’t hesitate to contact us at 763-684-0075, ext.
100. Once your registration is received, you will be contacted by our welcoming
committee. We are excited to have you join our parish community!
Peace,
Fr. Nathaniel Meyers, Pastor
Registration Form Instructions
1. Please fill in blanks and circle the correct answers as indicated.
2. The MAILING LABEL should include your name and address as you would like it to
appear on any mail you receive from St. Francis Xavier Church. For example: Mr. &
Mrs. John Smith, The Johnson Family, Joe & Susan Jones, Mrs. Nancy Fields, etc.
3. HEAD OF HOUSEHOLD should be filled out by the head(s) of the household.
Married couples should complete information for each spouse, whether or not they
are Catholic.
4. CHILD (Living in Household) should be filled out for each child living in your home.
Children who have graduated from high school may fill out a separate form if
he/she would like to be registered as an individual adult member.
Mailing Label:
Mailing Address:
City:
State: MN Zip:
Home Phone: (
)
-
Head of Household
NAME – First:
Middle:
Maiden Name:
Date of Birth:
Last:
/
/
Gender: M
F
Religion:
Baptized: YES
NO
First Communion: YES
Status: Married (Catholic) Married (Civil/Other)
Employer:
NO
Confirmed: YES
Single
Widowed
NO
Divorced
OR Self-Employed Homemaker Student
Work Phone: (
)
Personal Cell Phone: (
)
-
Personal Email:
Head of Household (Spouse)
NAME – First:
Middle:
Maiden Name:
Date of Birth:
Last:
/
/
Gender: M
F
Religion:
Baptized: YES
NO
First Communion: YES
Status: Married (Catholic) Married (Civil/Other)
Employer:
Work Phone: (
Personal Cell Phone: (
Personal Email:
NO
Single
Confirmed: YES
Widowed
NO
Divorced
OR Self-Employed Homemaker Student
)
)
-
Child (Living in Household)
NAME – First:
Date of Birth:
Middle:
/
/
Last:
Gender: M
School Grade:
F
Religion:
Baptized: YES NO
First Communion: YES NO
Confirmed: YES NO
Child (Living in Household)
NAME – First:
Date of Birth:
Middle:
/
/
Last:
Gender: M
School Grade:
F
Religion:
Baptized: YES NO
First Communion: YES NO
Confirmed: YES NO
Child (Living in Household)
NAME – First:
Date of Birth:
Middle:
/
/
Last:
Gender: M
School Grade:
F
Religion:
Baptized: YES NO
First Communion: YES NO
Confirmed: YES NO
Child (Living in Household)
NAME – First:
Date of Birth:
School Grade:
Baptized: YES NO
Middle:
/
/
Last:
Gender: M
F
Religion:
First Communion: YES NO
Confirmed: YES NO
Involvement
If you would like to be contacted by one of the individuals below, please put a
check mark next to their name.
_______
Father Nathaniel Meyers, Pastor
_______
Alisa Louwagie, Saint Francis Xavier School Principal
_______
Debbie Gladitsch, Director of Youth Formation & Ministry
_______
Toni Diem, Director of Music
There are a number of other ministries at Saint Francis Xavier. You will receive
more information regarding these ministries, and other ways to get involved, from
Kathy Kuzma, the chair of our welcoming committee.

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