PASSPORT
PICTURE
CORPUS CHRISTI CATHOLIC CHURCH, SAKUMONO
PERSONAL DATA
PERSONAL DETAILS
1.
Name: Mr/Mrs/Miss/Dr/Prof Surname:……….………………....… Other name(s) ……………………..………………………..
2.
Sex: Male/Female (Please underline)
3.
Date of Birth: …… …//…………//………… Place of Birth: ………….………………………………………………………..
(dd/mm/year)
4.
Nationality:……………………… Home Town: ………………..………
District of Home town:………….…………………
Region of hometown………………………………………………….
5.
Residential Address:…………………………………………………………………………………………………………………
6.
Postal Address:…………………………………………………………………. E-mail: …………………………………………
7.
Phone No 1.:…………………………………..…………...
8.
Father’s Name:…………………………………………………. Mother’s Name:………………………………………………...
9.
Marital status (Please Tick): Single
Phone No. 2 ………………………………………………………..
Married
Separated
Divorced
Widowed
If married provide details below:
Type of marriage:
Customary
Catholic Ordinance
Ordinance in Other Church
State date of marriage: Date…...…//………//………. Place of marriage: Town………………….…… Church…………………..…..
(dd/mm/year)
10. Name of Spouse:………………………………………………………….. Nationality:……………………………………………
11. Spouse’s Religious Denomination:……………………………………….… Spouse’s Phone No.:……………………………......
OCCUPATIONAL DATA
Occupational Statius:
Employed
Unemployed
Student
Retired
12.
If employed state: a) Name of institution………………………………………… b) Profession….. ………………………….
13.
If student state :
a) Name of Institution:……………………………………… ... b) Year of entry…………….…...….... …..
c) Educational Level (Underline): i) Basic ii) Second Cycle iii) Tertiary (State area of study …………..……..)
14.
SACRAMENTS
Sacrament
Baptism
1st Communion
Confirmation
1=Yes ; 2=No
Date ( dd/mm/year)
Place
Parish
15.
SERVICE TO CHURCH/MINISTRIES
1=Yes ;
2=No
Ministry
Year of
joining
Usher
Lector
Knights and Ladies of the Altar
Membership on Council
Parish/Church Youth Council
Parish/Church Pastorial Council
1=Yes
2=No
Name
(Please underline)
Parish Choir;
Philharmonic Choir
Corpus Christi Singing Ministry;
Santified Voices
Singining
Ministries
1st Term (eg
2013-2014)
2nd Term
3rd Term
4th Term
5th Term
Year of
joining
6th Term
MEMBERSHIP OF GROUPS/SOCIETIES
16.
Day Group:………………………………………… Year of joining ....................................................................................
17.
Society (ies):……………………………………………………………………………………………………………………..
18.
CHILDREN’S RECORDS (Provide data where applicable. Add a supplementary sheet if space provided is
inadequate)
NAME OF CHILD
DATE OF
BIRTH
(dd/mm/year)
PLACE OF 1ST
COMMUNION
PLACE OF BAPTISM
Church
Town
Church
19. Previous Church/Parish:………………………………………………….….
Town
PLACE OF
CONFIRMATION
Church
Town
Location:………………...……………………
20. Date Joined Corpus Christi Catholic Church/Parish: ……….…//………..…//……………..
(dd/mm/year)
21. Signature:…………….………………..
Date: ………..…//……………//……………
(dd/mm/year)
Thank you for taking the time to have this form well completed. It will enable us serve you better. (Parish Priest)
-------------------------------------------------------------------FOR OFFICE USE ONLY (Records and Approval)
Name
Signature
Date ( dd/mm/year)
Captured by
Verified by
Membership Number Assigned :………………………………………… Date: ………….…
Parish Priest: Name … Rev. Fr. Joseph H. Mensah ….. Signature …………………………………Date: ………………….