Holy Rosary
Catholic Church

Served by the Scalabrinian
missionaries since 1890

911 E. Missouri Avenue, Kansas City, Missouri

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• 816.842.5440

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• Email the Parish Secretary

For New Parishoners

Please complete this form and click the Submit button at the bottom when finished. This information will be sent to the parish office. The pastor will contact you to help you complete the process to join Holy Rosary Parish. All information will remain confidential.

If you prefer not to use this online form, please call the pastor at 816.842.5440. Or send email to the pastor

Family Name (last name)
Street Address
City State Zip Code
Home Phone
Cell Phone
Head of Household Name
Date of Birth	(mm/dd/yyyy)
Race
Catholic	Yes    No
Religion
Baptized	Yes    No
Confirmed	Yes No
Church where Baptized:
Spouse (if applicable) Name
Date of Birth
Race
Catholic	Yes    No
Religion
Baptized	Yes    No
Confirmed	Yes No
Church where Baptized:
Catholic Priest	Yes    No
Married by Other
Date of Marriage	(mm/dd/yyyy)
Marital Status	Single Never married Divorced Separated Widow Widower
Other Adults living in Household (eg., mother, father, siblings, etc.)
Children	Yes    No
Childs Name
Gender	Male    Female
Date of Birth
Baptized	Yes    No
What school do they attend?
Grade level

Holy Rosary Catholic Church   911 E. Missouri Avenue, Kansas City, Missouri 64106   816.842.5440