Information Update

Head of Household (HH)

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

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

Date of Birth (MM/DD/YYYY) Please enter a date.

Religion Please enter valid data.

Street Address of Household Residence Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Mailing Address (if different than street address) Please enter valid data.

Household Email Please enter an email address.

Household Phone Number Please enter a phone number.

HH Phone Number Please enter a phone number.

Accepts texts?

HH's Occupation

HH's Talents Offered

Parish Support Preference Offering Envelope Electronic Giving

Household Privacy (check all that apply) Publish household name/address in parish directory. Publish household phone number in parish directory. Publish household e-mail address in parish directory. Do not publish household information in parish directory.

Other Household Members

Number of Other Household Members REQUIRED
Select the number of other household members (to include spouse, child/children or other) and provide the additional information requested.
Please fill out this field.
Other Household Member 1
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 2
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 3
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 4
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 5
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 6
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 7
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 8
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 9
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 10
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 11
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 12
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 13
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 14
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered
Other Household Member 15
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship to HH Please enter valid data.
- Religion Please enter valid data.
- Email Please enter an email address.
- Date of Birth (MM/DD/YYYY) Please enter a date.
- Phone Number Maximum 20 characters Please enter a phone number.
- Accepts texts?
- Student?
- If yes, select all that apply: Student - Angel House (childcare) Student - QHR-Wea School Student - School of Religion Student - Home School Student - Catholic HS Student - Public HS Student - College
- Occupation
- Talents Offered

Queen of the Holy Rosary - Wea	Parish	School
22779 Metcalf Rd.	p. (913) 533-2464	p. (913) 533-2462
Bucyrus, KS 66013	e. parish@qhrwea.org	e. nick@qhrwea.org