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

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State REQUIRED Please fill out this field.

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

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 REQUIRED Please fill out this field.

Adult 2

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 REQUIRED Please fill out this field.

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

Number of Children REQUIRED Please fill out this field.

Children 1 (in the home)

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.
Last Name (if different) 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.
First Communion REQUIRED Yes No Please fill out this field.
Confirmed REQUIRED Yes No Please fill out this field.

Children 2 (in the home)

Would you like to receive Parish Collection Envelopes? REQUIRED Yes No Please fill out this field.

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

Do we have your permission to send you messages? REQUIRED Yes No Please fill out this field.

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