St. Wenceslaus Eucharist/Reconciliation Registration
Please complete the form below and return to the church office with a copy of candidate’s baptism certificate.
Child's Name *
Your answer
Sex of Child
Date of Birth
MM
/
DD
/
YYYY
Current Grade Level
Your answer
Father's Name
First & Last Names
Your answer
Mother's Name
First & Last Names
Your answer
Mother's Maiden Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone Number
Your answer
E-mail Address
Your answer
Child's Place of Birth
City, State
Your answer
Date of Child's Baptism
MM
/
DD
/
YYYY
Church of Baptism
Your answer
City and State of Baptism
Mailing Address, City, State
Your answer
Submit
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