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Family Last Name REQUIRED Please fill out this field. Please enter valid data.

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 Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Family Email REQUIRED Please fill out this field. Please enter an email address.

Adult 1

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle/ Maiden Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
Baptized REQUIRED Yes No Please fill out this field.
Date and Place of Baptism Please enter valid data.
Confirmed REQUIRED Yes No Please fill out this field.
Occupation Please enter valid data.
Special Skills, 2nd Language, etc. Please enter valid data.
Marital Status

Adult 2

Number of Children REQUIRED Please fill out this field.

Children 1 (in the home)

Children 2 (in the home)

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Would you prefer Online Giving? REQUIRED Yes No Please fill out this field.

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If you have any questions of concerns, please contact the parish office Concord: 978-369-7442 or St. Irene: 978-369-3940