Parishioner Information
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Name *
Last, First MI
Birth Date *
MM
/
DD
/
YYYY
Place of Birth *
City, State or Foreign Country
Current Address
Street Address
City, State
Zip Code
Home Phone
(123)456-7890
Cell Phone
(123)456-7890
Email Address
Employer
Your employer
Phone Number
(123)456-7890
Marital Status *
Please pick one
Spouse's/Partner's Name
Date of Marriage
MM
/
DD
/
YYYY
Children
1st Child's Name
1st Child's Birth Date
MM
/
DD
/
YYYY
2nd Child's Name
2nd Child's Birth Date
MM
/
DD
/
YYYY
Previous Church
Previous Church Name/Affiliation/Denomination
Previous Church City, State
Baptism
Name of Church where Baptised
Denomination of Baptism Church
Date of Baptism
MM
/
DD
/
YYYY
Baptism Church's City, State
Confirmation
Name of Church where Confirmed
Denomination of Confirmation Church
Date of Confirmation
MM
/
DD
/
YYYY
Confirmation Church's City, State
Confirmation Church's Telephone
(123)456-7890
Spouse/Partner
Previous Church
Spouse's Previous Church's Name/Affiliation/Denomintation
Spouse's Previous Church's City, State
Baptism
Name of Church where Spouse was Baptised
Denomination of Church where spouse was Baptised
Date of Spouse's Baptism
MM
/
DD
/
YYYY
City, State of Church where Spouse was Baptised
Confirmation
Name of Church where Spouse was Confirmed
Denomination of Church where Spouse was Confirmed
Date of Spouse's Confirmation
MM
/
DD
/
YYYY
City, State of Church where Spouse was confirmed
Telephone of Church where Spouse was Confirmed
(123)456-7890
Please note your personal information, name, address, telephone number will be placed in St. Anna's church directory that is provided to the church membership
Please check whether or not you would like to have your information in the church directory. If you have any questions regarding this please contact the office at 947-2121.
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