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Today's Date: Family Surname: Address: Apt #: City: State: Zip: Telephone Numbers: Home: Cell: Work: Email Address: First Name: Birth Date: Religion: Occupation: Employer: Spouse: Religion: Birth Date: Date of Marriage: Occupation: Employer: Children Living at Home: Birth Date: Birth Date: Birth Date: Birth Date: Would you like to receive the diocesan newspaper free of charge? Yes No Please tell us some areas of parish life in which you might be interested: St. Mary's School Women's Guild Men's Club Lector Usher Minister of Communion Choir Meals- Convalescing Families Religious Education (CCD) Vacation Bible School Annual Easter Egg Hunt
Today's Date:
Family Surname:
Address: Apt #:
City: State: Zip:
Telephone Numbers: Home: Cell: Work:
Email Address:
First Name:
Birth Date: Religion:
Occupation: Employer:
Spouse: Religion:
Birth Date: Date of Marriage:
Children Living at Home:
Birth Date:
Would you like to receive the diocesan newspaper free of charge? Yes No
Please tell us some areas of parish life in which you might be interested: