PHONE: 973-379-3912 ~ FAX: 973-379-5356
50 SHORT HILLS AVE. SHORT HILLS, NJ 07078

For God so loved the world, that he gave his only begotten Son, that whoever believes in him should not perish, but have everlasting life. - John 3:16

Parish Registration

Welcome Note from our Pastor, Very Reverend Larry Evans

Welcome to your new parish! St. Rose of Lima is a place of prayers, service and family. We are glad to have the chance to share our ministries and activities with you including our Faith Formation sacramental programs.

We invite you to learn about our wonderful parish by visiting our web page for Mass times & upcoming events!

Please complete the Registration Form below.  Upon completion, you will have the opportunity to also register for Online e-Giving.
If you prefer, you may download the Parish Registration Form HERE.  Then just complete the hard copy and drop it off at the Parish Office.

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Household Information

Family Name
Address
City/State/Zip
Home Telephone
Family Email
Former Parish (Name/Location)

Please choose how you would like to donate to the Parish

Contribution Method
Receive Contribution Envelopes
Online e-Giving

Marriage Information

Marital Status
Single
Married in Catholic Church
Married Elsewhere
Widowed
Separated
Divorced
Date/Place of Marriage
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Head of Household

Name
Cell Phone Number
Email Address
Occupation
Birth Date (Mo/D/Yr)
Religion
Baptism
Yes
No
Location
First Penance
Yes
No
Location
First Communion
Yes
No
Location
Confirmation
Yes
No
Location
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Spouse

Name
Cell Phone Number
Email Address
Occupation
Birth Date (Mo/D/Yr)
Religion
Baptism
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No
Location
First Penance
Yes
No
Location
First Communion
Yes
No
Location
Confirmation
Yes
No
Location
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Child 1

Name
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Male
Female
Grade
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Birth Date (Mo/D/Yr)
Religion
Baptism
Yes
No
Location
First Penance
Yes
No
Location
First Communion
Yes
No
Location
Confirmation
Yes
No
Location
Do you want to register this child for the St. Rose Faith Formation program?
Yes
No
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Child 2

Name
Gender
Male
Female
Grade
School Attending
Birth Date (Mo/D/Yr)
Religion
Baptism
Yes
No
Location
First Penance
Yes
No
Location
First Communion
Yes
No
Location
Confirmation
Yes
No
Location
Do you want to register this child for the St. Rose Faith Formation program?
Yes
No
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Child 3

Name
Gender
Male
Female
Grade
School Attending
Birth Date (Mo/D/Yr)
Religion
Baptism
Yes
No
Location
First Penance
Yes
No
Location
First Communion
Yes
No
Location
Confirmation
Yes
No
Location
Do you want to register this child for the St. Rose Faith Formation program?
Yes
No
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Additional Household Member 1

Name
Birth Date (Mo/D/Yr)
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Religion
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Additional Household Member 2

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Religion
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Additional Household Member 3

Name
Birth Date (Mo/D/Yr)
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Religion
Submit
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