Register

- Register
Contact
- Margaret Roddy
  
  Pastoral Minister for Church Management and Sacrament Coordination
  
  732-264-4712 ext. 17
  roddystbenedictnj.org

New Parishioner Registration

If you prefer to download, print, and return the filled out registration form to the Parish Office: Click Here

Otherwise, please fill out the online form below and the Parish Office will process your registration.
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The maximum number of form submissions has been reached. This form is currently not available.
- Please make sure to fill out all required fields below in order to complete online registration. Mandatory fields include: Name, Email, Full Address and Sacraments for each person. Fields left blank will make the registration form incomplete and therefore will not be processed.
- Household Information
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- 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.
- Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Number Maximum 20 characters Please enter a phone number.
- Parish Pay Yes No
- Envelope Number Please enter valid data.
- Head of Household 1
- Title REQUIRED Mr. Mrs. Ms. Miss Dr. Please fill out this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name (if applicable) Please enter valid data.
- Sex REQUIRED Male Female Please fill out this field.
- Birthdate REQUIRED Please fill out this field. Please enter a date.
- Religious Denomination REQUIRED Please fill out this field. Please enter valid data.
- Marital Status REQUIRED Married (Married in a Catholic Church) Married Civily Single Divorced Widowed Please fill out this field.
- Sacraments Received (Check All That Apply): REQUIRED Catholic Baptism First Communion Confirmation Please fill out this field.
- Head of Household 2
- Title REQUIRED Mr. Mrs. Ms. Miss Dr. Please fill out this field.
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Maiden Name (if applicable) Please enter valid data.
- Sex Male Female
- Birthdate Please enter a date.
- Religious Denomination Please enter valid data.
- Marital Status Married (Married in a Catholic Church) Married Civily Single Divorced Widowed
- Sacraments Received (Check All That Apply): Catholic Baptism First Communion Confirmation
- Child 1 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Sex Male Female
- Birth Date Please enter a date.
- Religious Denomination Please enter valid data.
- Sacraments Received (Check All That Apply): Catholic Baptism First Communion Confirmation
- Attending Catholic School? Yes No
- Attending RE? Yes No
- Child 2 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Sex Male Female
- Birth Date Please enter a date.
- Religious Denomination Please enter valid data.
- Sacraments Received (Check All That Apply): Catholic Baptism First Communion Confirmation
- Attending Catholic School? Yes No
- Attending RE? Yes No
- Child 3 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Sex Male Female
- Birth Date Please enter a date.
- Religious Denomination Please enter valid data.
- Sacraments Received (Check All That Apply): Catholic Baptism First Communion Confirmation
- Attending Catholic School? Yes No
- Attending RE? Yes No
- Child 4 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Sex Male Female
- Birth Date Please enter a date.
- Religious Denomination Please enter valid data.
- Sacraments Received (Check All That Apply): Catholic Baptism First Communion Confirmation
- Attending Catholic School? Yes No
- Attending RE? Yes No
- I understand that my weekly Mass attendance to fulfill the Sunday obligation can only be determined through the use of envelopes. Please click "I Agree" below.
  I Agree Please select this field.
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Register

Please make sure to fill out all required fields below in order to complete online registration. Mandatory fields include: Name, Email, Full Address and Sacraments for each person. Fields left blank will make the registration form incomplete and therefore will not be processed.

Household Information

Head of Household 1

Head of Household 2

Child 1 Information

Child 2 Information

Child 3 Information

Child 4 Information