Join the Shrine Parishes

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name 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.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Is your phone unlisted? Yes

Which Parish Would You Like to Register In? REQUIRED Immaculate Heart of Mary (Polish Hill) Most Holy Name of Jesus (Troy Hill) Saint Nicholas (Millvale) Saint Patrick - Saint Stanislaus Kostka (Strip District) Please fill out this field.

Head of Household Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Title Please enter valid data.

Suffix Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Gender REQUIRED Male Female Please fill out this field.

Religion if not Catholic Please enter valid data.

Marital Status REQUIRED Please fill out this field. Please enter valid data.

Catholic Marriage? Yes No

If Applicable - Date of Marriage Please enter valid data.

If Applicable-Place of Marriage (Church, City, and State) Please enter valid data.

If Applicable Maiden Name Please enter valid data.

Occupation REQUIRED Please fill out this field. Please enter valid data.

Employer REQUIRED Please fill out this field. Please enter valid data.

Education and grade or degree completed Please enter valid data.

Check all Sacraments received. REQUIRED Baptism First Communion Confirmation Please fill out this field.

If non-Catholic Baptism, please enter other denomination Please enter valid data.

Additional Comments

Spouse/Family Member

If more than one family member is being registered please continue. If only a head of household is registering, please click submit at the bottom of the form. Thanks.

First Name Please enter valid data.

Last Name Please enter valid data.

Suffix Please enter valid data.

Title Please enter valid data.

Relationship to head of household Spouse Child Other

If other, please specify Please enter valid data.

Email Please enter an email address.

Date of birth Please enter a date.

If Applicable - Date of Marriage Please enter valid data.

Gender Male Female

Religion if not Catholic Please enter valid data.

Marital Status REQUIRED Please fill out this field. Please enter valid data.

Catholic Marriage? Yes No

If Applicable - Place of Marriage (Church, City, and State) Please enter valid data.

If Applicable Maiden Name Please enter valid data.

Occupation Please enter valid data.

Employer Please enter valid data.

Education and grade or degree completed Please enter valid data.

Check all Sacraments received Baptism First Communion Confirmation

If non-Catholic Baptism, please enter other denomination Please enter valid data.

Additional Comments

Additional Family Members REQUIRED Please fill out this field. Please enter valid data.

Additional Member 1

First Name Please enter valid data.

Last Name Please enter valid data.

Title Please enter valid data.

Suffix Please enter valid data.

Email Please enter an email address.

Relationship to head of household Child Other

If other, please specify Please enter valid data.

Gender Male Female

Date of Birth Please enter a date.

Check all Sacraments received Baptism First Communion Confirmation

If non-Catholic Baptism, please enter other denomination Please enter valid data.

Education - with grade or degree received Please enter valid data.

Additional comments

Saint Anthony Chapel 1704 Harpster Street Pittsburgh, PA 15212 (412) 999-4401	Immaculate Heart of Mary 3058 Brereton Street Pittsburgh, PA 15219 (412) 621-5170	Most Holy Name of Jesus 1700 Harpster Street Pittsburgh, PA 15212 (412) 231-2994
Saint Nicholas 24 Maryland Avenue Pittsburgh, PA 15209 (412) 821-3438	Saint Patrick 1711 Liberty Avenue Pittsburgh, PA 15222 (412) 471-4767	Saint Stanislaus Kostka 57 21st Street Pittsburgh, PA 15222 (412) 471-4767

Join the Shrine Parishes

New members are always welcome!