RCIA Registration - St. John Nepomuk
First Name *
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Middle Name *
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Last Name *
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Maiden Name (if applicable)
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Date of Birth *
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Place of Birth (City, State) *
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Father's First AND Last Name *
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Mother First and MAIDEN Name *
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Mailing Address (street, city, zip) *
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Best Phone Number *
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E-Mail Address that you check at least weekly *
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Occupation *
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If you know who your RCIA sponsor will be, enter their name here.
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What, if any, is your present religious affiliation? *
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Have you ever been baptized? *
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