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Confirmation Registration 2022-202
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* Indicates required question
Student Information
First Name
Your answer
Last Name
Your answer
Gender
Female
Male
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Birth Date
MM
/
DD
/
YYYY
Will you turn 18 years old during the 2021-2022 school year?
Yes
No
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Address
Your answer
City/Zip Code
Your answer
Grade Level (Fall 2021)
*
Choose
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Option 8
School
Your answer
Baptized in the Church of:
Your answer
City/State
Your answer
Are you a St. Vincent de Paul Parishioner?
Yes
No
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Primary Parent/Guardian Information
Mother's Name (First and Last)
Your answer
Father's Name (First and Last)
Your answer
Address (if different from student)
Your answer
City/Zip (if different from student)
Your answer
Home # or Cell #
Your answer
Email Address
Your answer
Are you interested in volunteering as a group facilitator?
Yes
No
Clear selection
Have you had Virtus training?
Yes
No
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Submit
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