Parish Registration Form
*
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First Name *
Your answer
Are You Currently a Roman Catholic? *
Address Line 1 *
Street Address, P.O. Box
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Address Line 2
Apartment, Building, Suite, etc.
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City *
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State *
Your answer
Zip Code *
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Home Phone Number *
Your answer
Email Address *
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Marital/Engagement Status *
Your answer
If married, where?
Parish, City, State
Your answer
Anniversary Date
Your answer
Number of Children
Your answer
Member Information
Head of Household *
First Name, Middle Initial, Last Name (Maiden Name)
Your answer
Date of Birth *
Your answer
*
Sacraments Received *
Required
Spouse
First Name, Middle Initial, Last Name (Maiden Name)
Your answer
Date of Birth
Your answer
Sacraments Received
Child 1
First Name, Middle Initial, Last Name
Your answer
Date of Birth
Your answer
Sacraments Received
Child 2
First Name, Middle Initial, Last Name
Your answer
Date of Birth
Your answer
Sacraments Received
Child 3
First Name, Middle Initial, Last Name
Your answer
Date of Birth
Your answer
Sacraments Received
Child 4
First Name, Middle Initial, Last Name
Your answer
Date of Birth
Your answer
Sacraments Received
Child 5
First Name, Middle Initial, Last Name
Your answer
Date of Birth
Your answer
Sacraments Received
More Children
please include full names and Sacraments received
Your answer
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