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Join Our Parish

- Welcome from our pastor
  
  Welcome!
  We are delighted that you are interested in joining Sacred Heart Parish. We are located in Glyndon, but people from all over the world make up our congregation. It is our hope that you will find a new community here. Our Pastoral Staff is here to assist you in your faith journey. Please contact us if we can be of assistance.
  
  Our parish community thrives because people use thier gifts and talents to help in many ways. It is what makes us a family in faith. We have many volunteer opportunities available. Keep a lookout in our weekly bulletin or Flocknote e-mail for ways to get to personally know our parishioners as well as our staff. We look forward to being your faith community for many years to come.
  
  Fr. Gerard Francik
- Online parish registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Family Information
  
  Family last name REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing name Please enter valid data.
  
  Family email address REQUIRED Please fill out this field. Please enter an email address.
  
  Home phone number Maximum 20 characters Please enter a phone number.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Mailing address REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing address (line 2) 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.
  
  Primary language English Spanish Other
  
  Head of Household
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email address Please enter an email address.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Are you baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received first Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Additional household members REQUIRED
  To enter the information for other members of your household, increase the number below.
  Please fill out this field.
  
  Family Member 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
  Work phone number Maximum 20 characters Please enter a phone number.
  
  Occupation Please enter valid data.
  
  Special needs Please enter valid data.
  
  Religion REQUIRED Roman Catholic Other: Christian Other: Non-Christian Please fill out this field.
  
  If "other" religion, please describe
  Anglican, Baptist, Lutheran, Methodist, Presbyterian, Orthodox, Jewish, Muslim, Hindu, etc.
  Please enter valid data.
  
  Have you been baptized? Yes
  
  IF YES: date of your Baptism Please enter a date.
  
  Church of your Baptism
  Please provide the name of the church where you were baptized, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received First Eucharist? Yes
  
  IF YES: date of your first Eucharist Please enter a date.
  
  Church of your first Eucharist
  Please provide the name of the church where you received first Eucharist, along with the church's city and state or country.
  Please enter valid data.
  
  Have you received Confirmation? Yes
  
  IF YES: date of your Confirmation Please enter a date.
  
  Church of your Confirmation
  Please provide the name of the church where you were confirmed, along with the church's city and state or country.
  Please enter valid data.
  
  Are you married? Yes: married in the Catholic Church Yes: married outside of the Catholic Church Not married
  
  Your wedding date Please enter a date.
  
  Church of your wedding (if in church)
  Please provide the name of the church where you were married, along with the church's city and state or country.
  Please enter valid data.
  
  Family Member 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden last name
  If married
  Please enter valid data.
  
  Relationship to the Head of Household REQUIRED Spouse Son Daughter Grandchild Parent Other Please fill out this field.
  
  Date of birth REQUIRED
  You can choose a date from the calendar below or type the date in "99/99/9999" format.
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Cell phone number Maximum 20 characters Please enter a phone number.
  
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