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Registration Form

Information Required

Your full name: *

Birthday (mm/dd/yy): *

Major: *

Graduation year: *

Phone: *

Email: *

Parent/Guardian names: *

Home address

Street, City, State, Zip: *

Home parish and address

Name, Street, City, State, Zip: *

Best way to contact you: *

I want information about:

Would you like to be prepared to receive First Communion and/or Confirmation?

Please select: *