Become a Parishioner

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Today's Date REQUIRED Please fill out this field. Please enter valid data.
Primary Contact
Last Name REQUIRED Please fill out this field. Please enter valid data.
First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name (if applicable) Please enter valid data.
Title (Mr, Ms, Mrs, Dr, etc) Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Email REQUIRED Please fill out this field. Please enter an email address.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Were you Baptized? REQUIRED Yes No Please fill out this field.
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Were you Confirmed? REQUIRED Yes No Please fill out this field.
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Have you received your First Communion? REQUIRED Yes No Please fill out this field.
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Were you married in the Catholic Church? REQUIRED Yes No Please fill out this field.
If you answered Yes to the above question, please provide the date. Please enter valid data.
If you were not married in the Catholic Church, please explain when, where, and how you were married.
Gender REQUIRED Male Female Please fill out this field.
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Spouse Information
Last Name Please enter valid data.
First Name Please enter valid data.
Middle Name Please enter valid data.
Maiden Name (if applicable) Please enter valid data.
Title (Mr, Ms, Mrs, Dr, etc) Please enter valid data.
Date of Birth Please enter valid data.
Religion Please enter valid data.
Email Please enter an email address.
Phone Number Maximum 20 characters Please enter a phone number.
Were you Baptized? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Were you Confirmed? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Have you received your First Communion? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Gender Male Female
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Children
Please include only those children who are under the age of 18 and currently live with you.
Child One
Last Name Please enter valid data.
First Name Please enter valid data.
Middle Name Please enter valid data.
Date of Birth Please enter valid data.
Religion Please enter valid data.
Current School Please enter valid data.
Has this child been Baptized? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child been Confirmed? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child received their First Eucharist? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Gender Male Female
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Child Two
Last Name Please enter valid data.
First Name Please enter valid data.
Middle Name Please enter valid data.
Date of Birth Please enter valid data.
Religion Please enter valid data.
Current School Please enter valid data.
Has this child been Baptized? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child been Confirmed? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child received their First Eucharist? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Gender Male Female
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Child Three
Last Name Please enter valid data.
First Name Please enter valid data.
Middle Name Please enter valid data.
Date of Birth Please enter valid data.
Religion Please enter valid data.
Current School Please enter valid data.
Has this child been Baptized? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child been Confirmed? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Has this child received their First Eucharist? Yes No
If you answered Yes to the above question, please provide the approximate date. Please enter valid data.
Gender Male Female
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For additional children, please get in touch with the parish office.
Please select any of those options below you would like more information about! Alter Serving Church Cleaning and Beautification Eucharistic Minister Justice and Peace Ministry Lector Chior Religious Education Youth Ministry Bible Study Usher/Greeter
Do you or someone in your household need to receive one of the Sacraments or want to become Catholic? (Please list the sacraments you need, become Catholic, or no.) REQUIRED Please fill out this field.
Please let us know if you would like more information about parish events or anything else we can help you with!

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St. Bernadette Catholic Church

9020 E 51st Ter Kansas City, MO 64133
816-356-3700

Become a Parishioner