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Parish Enrollment/Registration

- Welcome
  
  We invite you to join Saint Benedict the Moor Parish, a Personal Parish for Black Catholics in Pittsburgh.
- We would love to have you as part of our parish family.
  
  You can enter up to ten family members in the fields below. If you have more than ten family members, submit the form once, and then a second time with the additional family members.
  
  Please fill out the fields that apply to you and your family/household.
- Household Information
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Family Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  Address 2 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.
  
  Stewardship REQUIRED Monthly Envelopes Please fill out this field.
  
  Request for parish assistance with Communion visits, transportation to Mass, or accessibility questions. Please enter valid data.
  
  Number of Family Members or People in Your Household REQUIRED Please fill out this field.
  
  Member 1
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 2
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 3
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 4
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 5
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 6
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 7
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 8
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 9
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Member 10
  
  Prefix REQUIRED Please fill out this field.
  
  First Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Preferred First Name Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Relationship REQUIRED Adult Single Husband Wife Son Daughter Other Please fill out this field.
  
  If Other, please specify relationship. Please enter valid data.
  
  Religion Roman Catholic Other
  
  If Other, please specify. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parish Communication (Regular Emails) REQUIRED Yes No Please fill out this field.
  
  What Catholic sacraments have you received? REQUIRED None Baptism First Communion Confirmation Matrimony Unknown Please fill out this field.
  
  Marital Status REQUIRED Married Single Widowed Divorced Not Applicable Please fill out this field.
  
  If you were not married in the Church... Another Denomination Civil Ceremony
  
  Occupation or Retired REQUIRED Please fill out this field. Please enter valid data.
  
  Child: School and Grade Please enter valid data.
  
  Submit
  
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- Paper Enrollment Form
  
  The completed form may be mailed to the Parish Office, 91 Crawford Street, Pittsburgh PA 15219, or emailed to [email protected].
  
  Enrollment Form
  
  Please call 412.281.3141 with any questions.
- Saint Benedict the Moor Church
- Where to find us

Parish Enrollment/Registration

We invite you to join Saint Benedict the Moor Parish, a Personal Parish for Black Catholics in Pittsburgh.