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ST. MARY OF MT. CARMEL PARISH REGISTRATION FORM | |

|FAMILY INFORMATION |

|Date: | ~ New Registration __ Update | Parish Envelope #: |

| Ethnicity: _ Anglo/Caucasian _ Black/African American _ Filipino _ Hispanic __Other Contrib. Env. ____Y _____N |

|Family Name: | Title: ~ Mr. & Mrs ~ Miss____ Other |

|Address: | City/Zip Code |

|Home phone: |Cell phone: | Email: |

|Marriage date: | Church: | |

| | | City/State: |

|HEAD OF HOUSEHOLD INFORMATION |

|First Name: |Middle Name: | Last Name: |

|Date of birth: |Birth place: | Religion: |

| Marital Status: ~ Married ~ Single ~ Separated ~ Divorced ~ Annulled ~ Widowed |

|Baptism: Y N | Date: |Church: | City/State: |

|1st Communion: Y N | Date: |Church: | City/State: |

|Confirmation: Y N | Date: |Church: | City/State: |

|RCIA: Y N | Date: |Church: | City/State: |

|Occupation: |Employer: | Work phone: |

|SPOUSE INFORMATION |

|First Name: |Middle Name: |Last Name: | | Maiden Name: |

|Date of birth: | Birth place: |Religion: |

|Marital Status: ~ Married |~ Single ~ Separated ~ Divorced ~ Annulled ~ Widowed |

|Baptism: Y N | Date: |Church: | City/State: |

|1st Communion: Y N | Date: |Church: | City/State: |

|Confirmation: Y N | Date: |Church: | City/State: |

|RCIA: Y N | Date: |Church: | City/State: |

|Occupation: |Employer: | Work phone: |

|CHILD (or others living at home) |

|First Name: |Middle Name: | Last Name: |

|Date of birth: |Birth place: | Religion: |

| Relationship (eg. Son, Daughter): Ethnicity: _ Anglo/Caucasian _ Black/African American _ Filipino _ Hispanic __Other |

|Baptism: Y N | Date: |Church: | City/State: |

|1st Communion: Y N | Date: |Church: | City/State: |

|Confirmation: Y N | Date: | Church: | | City/State: |

|School: |Religious Ed Grade: |

|CHILD (or others living at home) |

|First Name: |Middle Name: | Last Name: |

|Date of birth: |Birth place: | Religion: |

| Relationship:(eg,Son,Daughter) Ethnicity: _ Anglo/Caucasian _ Black/African American _ Filipino _ Hispanic __Other |

|Baptism: Y N | Date: |Church: | City/State: |

|1st Communion: Y N | Date: |Church: | City/State: |

|Confirmation: Y N | Date: |Church: | City/State: |

|School: | Religious Ed Grade |

|ST. MARY OF MT. CARMEL PARISH REGISTRATION FORM |

|CHILD (or others living at home) |

|First Name: |Middle Name: |Last Name: |

|Date of birth: |Birth place: |Religion: |

|Relationship: Ethnicity: _ Caucasian _ Black/African American _ Filipino _ Hispanic __ |

|Other |

|Baptism: |Y |N | Date: |Church: |City/State: |

|1st Communion: |Y |N | Date: |Church: |City/State: |

|Confirmation: |Y | | |Church: | |

| | |N | Date: | |City/State: |

|Confirmation |Y | | | | |

|School: |Religious Ed Grade |

|CHILD (or others living at home) |

|First Name: |Middle Name: |Last Name: |

|Date of birth: |Birth place: |Religion: |

|Relationship: (eg. Son,Daughter): Ethnicity: _ Caucasian _ Black/African American _ Filipino _ Hispanic _ Other |

|Baptism: |Y |N | Date: |Church: |City/State: |

|1st Communion: |Y |N | Date: |Church: |City/State: |

|Confirmation: |Y |N | Date: |Church: |City/State: |

|School: |Religious Ed Grade |

|CHILD (or others living at home) |

| First Name: |Middle Name: |Last Name: |

|Date of birth: |Birth place: |Religion: |

|Relationship: (eg, Son,Daughter) Ethnicity: _ Caucasian __ Black/African American _ Filipino _ Hispanic _ Other |

|Baptism: |Y |N | Date: |Church: |City/State: |

|1st Communion: |Y |N | Date: |Church: |City/State: |

|Confirmation: |Y |N | Date: |Church: |City/State: |

|School: |Religious Ed Grade |

Any additional information:

St. Mary of Mt. Carmel Parish

226 French St.

Hammonton, NJ 08037

609-704-5945

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