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Parish Registration Form
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* Indicates required question
Email
*
Your email
Welcome to Our Lady of Lourdes
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
Email Address
Your answer
Cell phone number
*
Your answer
Home/Work phone
Your answer
Address
*
Your answer
Spouse/Partner First Name
Your answer
Spouse/Partner Last Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Spouse/Partner Email Address
Your answer
Cell Phone number
Your answer
Home/Work phone
Your answer
Alternate Address for seasonal parishioners
Your answer
Children's Names, Dates of Birth and School Attending
Your answer
Online Giving?
Yes
No
Clear selection
Need Envelopes
Yes
No
Clear selection
Send me a copy of my responses.
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