Reception & Reaffirmation Form
Full Name
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Address
(with city, state, zip)
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Cell #
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Email Address
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Date of Birth
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Gender
Most Recent Religious Affiliation
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Date of Baptism
MM
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DD
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YYYY
Name of Church
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Location of Church
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Date of Confirmation
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DD
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YYYY
Name of Church
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Location of Church
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Name of Bishop
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Denomination of Confirmation
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