Re-Imagine Church
 Encounter Jesus
 Live with Purpose

Click Submit Form to send this information to The Roman Catholic Parish of Middlebury and Southbury.

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*MIDD SOUTH CATHOLIC Register a New Family Update an Existing Family *ID/Env:  
HEAD OF HOUSEHOLD
*Title *First *Last Suffix
*Relationship   Nickname Maiden
*Birth Date *Gender Female   Male
Grade/Degree *Religion *MaritalStatus
  Occupation
*Phone ( ) - Unlisted
  Email   Unlisted
HEAD MINISTRIES   Name Interested in Joining
  
  
  
  
  
REMARKS    
SPOUSE
Title   First   Last
Relationship   Nickname Maiden
  Birth Date   Gender Female   Male
Grade/Degree   Religion MaritalStatus
  Occupation
  Email   Unlisted
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SPOUSE MINISTRIES   Name Interested in Joining
  
  
  
  
  
Remarks    
ADDRESS
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*City
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*ZIP
FAMILY PRIMARY PHONE/EMAIL
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Email
*Email   Unlisted
Send Email Instead of Mail When Possible
FAMILY GENERAL REMARKS
  Remarks
FAMILY MEMBERS
*Type  
*First *Last
*Relationship   Middle   Nickname
*Birth Date *Gender Female   Male
*Grade *Religion
MEMBER MINISTRIES   Name Interested in Joining
  
  
MEMBER REMARKS    

Click Submit Form to send this information to The Roman Catholic Parish of Middlebury and Southbury.

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