Registration Form

Church of the Presentation of the Blessed Virgin Mary

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Registration form

* Indicates required field

Family Last Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Email *

Head of Household Name *

First

Last

Date of Birth (Head of Household) *

Religion *

Marital Status *

Occupation *

Cell Phone Number *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

City of Baptism *

State of Baptism *

Name of SPOUSE (If Any) *

Date of Birth *

Religion *

Marital Status *

Occupation *

Spouse's Cell Phone Number *

Spouse's Sacraments *

Baptism First Communion Confirmation

Church of Baptism *

City of Baptism *

State of Baptism *

Child_1 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Child_2 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Child_3 /Other Member Name *

Date of Birth *

Gender *

Male Female

Religion *

Sacraments Received *

Baptism First Communion Confirmation

Church of Baptism *

State of Baptism *

Ministry Interest (Required) *

Altar Server Lector Music Eucharist Minister Hospitality RCIA Youth Ministry Catechetic Other - Please Contact Me

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Home
- All Are Welcome >
Sacraments
Ministries
Stewardship
Community
- Comunidad Hispano
- Filipino Community
Communication
Media Gallery
- Photos
- Videos