Family Last Name:*
Address:*
Phone:*
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E-mail:*
E-mail confirmation:*
Marital Status:
Date of Marriage:
Head of Household:
Birth Date:
Occupation:
Employer:
Business Phone #:
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Highest Level of Education:
Ministry Interests:
Religion:
Spouse (include maiden name):
Spouse Birth Date:
Spouse Occupation:
Spouse Employer:
Spouse Business Phone #:
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Spouse Highest Level of Education:
Spouse Ministry Interests:
Spouse Religion:
Child 1 First Name:
Child 1 Sex:
Child 1 Baptism:
Child 1 Disabled:
Child 1 Penance:
Child 1 First Eucharist:
Child 1 Confirmation:
Child 1 School/Occupation:
Child 1 Grade:
Child 1 Religion:
Child 1 Date of Birth:
Child 2 First Name:
Child 2 Sex:
Child 2 Baptism:
Child 2 Disabled:
Child 2 Penance:
Child 2 First Eucharist:
Child 2 Confirmation:
Child 2 School/Occupation:
Child 2 Grade:
Child 2 Religion:
Child 2 Date of Birth:
Child 3 First Name:
Child 3 Sex:
Child 3 Baptism:
Child 3 Disabled:
Child 3 Penance:
Child 3 First Eucharist:
Child 3 Confirmation:
Child 3 School/Occupation:
Child 3 Grade:
Child 3 Religion:
Child 3 Date of Birth:
Child 4 First Name:
Child 4 Sex:
Child 4 Baptism:
Child 4 Disabled:
Child 4 Penance:
Child 4 First Eucharist:
Child 4 Confirmation:
Child 4 School/Occupation:
Child 4 Grade:
Child 4 Religion:
Child 4 Date of Birth:
Other First Name:
Other Sex:
Other Baptism:
Other Disabled:
Other Penance:
Other First Eucharist:
Other Confirmation:
Other School/Occupation:
Other Grade:
Recaptcha Word Verification:
Other Religion:
Other Date of Birth: