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Parish Registry Application
After you have submitted your application a member ID will be provided to you
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* Indicates required question
Email
*
Your email
Family Representative Full Name
*
(Head of Household)
Your answer
Address
*
Name, Street, City, Zip Code
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
Your answer
Name of Emergency Contact
Your answer
Emergency Contact Phone Number
Your answer
Who lives in your household? Full Name and Relationship
I.E. Jesus of Nazareth, Brother
Your answer
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