Register as a Parishioner

If you wish to join the faithful of Sacred Heart Church in Moline, we offer two options for you to do so.

First, you are welcome to call the Parish Office at (309) 762-2362 and make an appointment to visit with the administrator or another staff person. You will receive a personal "welcome" to the parish, and you will be given a registration form to fill out.

Secondly, you may want to complete the more all-inclusive form on this page. Once you have completed the form, you may click on the "Submit" button and it will be emailed to the Parish Office.

A member of our Welcoming Committee will contact you soon and provide you with important papers and information relating to our church.

Lee Parish Center
1608 – 13th Street
Moline, IL 61265

Thank You and Welcome!

Family Registration Form

  • For date fields (mm/dd/yyyy) please double click on each section separately, then move on to next field. A correct format would be 07/18/1984, for example.
  • When you submit this form, all of the information will be sent by e-mail to Sacred Heart Church.

* Required fields
Head of Household
Title * First Name * Last Name Suffix
Birth Date: * Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm
Spouse
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm
Address
* Line 1
Line 2
* City
* State
* ZIP
E-Mail
Send E-Mail Instead of Mail When Possible
Phone
* Primary ( ) - Unlisted
Other ( ) - Unlisted

Member 1 - Type
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm

Member 2 - Type
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm

Member 3 - Type
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm

Member 4 - Type
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm

Member 5 - Type
Title First Name Last Name Suffix
Birth Date: Gender: Female Male
Sacraments Rcv Date
Baptism
1st Comm
Penance
Confirm

When you submit this form, all of the information will be sent by e-mail to Sacred Heart Church.