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  • Member of the Polish Apostolate Yes No
  • Update Registration Yes
  • Env# Please enter valid data.

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  • REASON FOR REGISTERING required REQUIRED OLLV School Baptism To be a Godparent/Sponsor First Holy Communion Confirmation Marriage OCIA (Formerly RCIA) Religious Education for Adults Other Please fill out this field.

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  • Would you like to receive monthly envelopes? REQUIRED YES NO Please fill out this field.

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  • HEAD of HOUSEHOLD
  • TITLE REQUIRED Mr. Mrs. Miss Ms. Dr. Deacon Please fill out this field.
  • Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Suffix Jr. Sr. II III IV
  • MAIDEN Name REQUIRED Please fill out this field. Please enter valid data.
  • First Name REQUIRED Please fill out this field. Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • MARITAL STATUS REQUIRED Single Married in the Roman Catholic Church Civil Marriage Validated in the Roman Catholic Church Civilly Married Widowed Divorced Please fill out this field.
  • Religion Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church

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  • SPOUSE
  • TITLE Mr. Mrs. Miss Ms. Dr.
  • Last Name Please enter valid data.
  • MAIDEN Name REQUIRED Please fill out this field. Please enter valid data.
  • First Name Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • MARITAL STATUS Single Married in the Roman Catholic Church Civil Marriage Validated in the Roman Catholic Church Civilly Married Widowed Divorced
  • Religion Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church

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  • CONTACT INFORMATION
  • Street Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    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.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Home Phone Maximum 20 characters Please enter a phone number.
  • Cell Phone Maximum 20 characters Please enter a phone number.
  • Email Please enter an email address.

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  • ADDITIONAL INFORMATION

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  • CHILDREN 
    UNDER the AGE OF 21  
    
    LIVING in the HOME
  • CHILD 1
  • Please Select Son Daughter Other
  • Clarify Other Please enter valid data.
  • Last Name Please enter valid data.
  • Suffix Jr. Sr. II III IV
  • First Name Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church
  • CHILD 2
  • Please Select Son Daughter Other
  • Clarify Other Please enter valid data.
  • Last Name Please enter valid data.
  • Suffix Jr. Sr. II III IV
  • First Name Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church
  • CHILD 3
  • Please Select Son Daughter Other
  • Clarify Other Please enter valid data.
  • Last Name Please enter valid data.
  • Suffix Jr. Sr. II III IV
  • First Name Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church
  • CHILD 4
  • Please Select Son Daughter Other
  • Clarify Other Please enter valid data.
  • Last Name Please enter valid data.
  • Suffix Jr. Sr. II III IV
  • First Name Please enter valid data.
  • Middle Name Please enter valid data.
  • Birth Date Please enter valid data.
  • Select Sacraments Received Baptized in the Roman Catholic Church Baptized in another Christian faith 1st Communion in the Roman Catholic Church Confirmation in the Roman Catholic Church

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