St. Rita Catholic Parish OCIA Enrollment Form

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St. Rita Catholic Parish OCIA Enrollment Form

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* Indicates required question

Name (Last): *

Your answer

Name (First): *

Your answer

Name (Middle): *

Your answer

Address: *

Your answer

City: *

Your answer

State: *

Your answer

Contact Phone number: *

Your answer

Email Address *

Your answer

Birth Date: *

MM

/

DD

/

YYYY

Age: *

Your answer

City and State of Birth: *

Your answer

Father's Full Name: *

Your answer

Mother's Full Name: *

Your answer

Mother's Maiden Name: *

Your answer

Are you registered at a Catholic parish? *

Yes

No

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