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  • Registration Date REQUIRED Please fill out this field. Please enter valid data.
  • I am registering for: REQUIRED St. Mary's St. Joseph-St. Therese Our Lady of Fatima Please fill out this field.
  • Previous Parish (if you attended another parish previously) REQUIRED Please fill out this field. Please enter valid data.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
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    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

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  • Household Name (your last name) REQUIRED Please fill out this field. Please enter valid data.
  • Status REQUIRED Single Married Divorced Widowed Please fill out this field.
  • If married, who were you married by? REQUIRED Catholic Priest or Deacon Other (Justice of the Peace or non Catholic Clergy) Please fill out this field.
  • Status of Adult 1 REQUIRED Single or Head of Household Husband Wife Please fill out this field.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Birthdate REQUIRED Please fill out this field. Please enter valid data.
  • Sacrament Received REQUIRED Baptism Eucharist (First Communion) Confirmation None of the Above Please fill out this field.
  • Occupation (if retired-enter retired) REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
  • Second Adult REQUIRED Please fill out this field. Please enter valid data.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Birthdate REQUIRED Please fill out this field. Please enter valid data.
  • Status of Adult 2 REQUIRED Wife Husband Other Adult in Household Please fill out this field.
  • Sacraments Received REQUIRED Baptism Eucharist (First Communion) Confirmation None of the Above Please fill out this field.
  • Occupation (If retired-enter retired) REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Additional Adults in Household REQUIRED Please fill out this field. Please enter valid data.
  • Sacraments Received REQUIRED Baptism Eucharist (First Communion) Confirmation None of the Above Please fill out this field.
  • • Children and School Grade Level REQUIRED Please fill out this field.
    • Child 1
    • Child 2
    • Child 3
    • Child 4
    • Child 5

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