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Head of Household
Name Last:
Name First:
Street Address:
PO Box:
City State, ZIP:
Home Phone:
Cell Phone:
E-mail Address:
Occupation:
Birth Date:
Sacraments Received:Baptized1st Penance1st CommunionConfirmedMarriage
Marital Status:SingleMarriedDivorcedSeparatedWidowed
START Spouse Information
Marriage Date:
Spouse First and Last Name:
Street Address (If different from above):
PO Box (If different from above):
City State, ZIP (If different from above):
Home Phone (If different from above):
END Spouse Information
Additional Household Information
Do you wish to receive mail:YesNo
Will you send electronic check (E-giving):YesNo
Do you wish to receive envelopes(no need if you e-give):YesNo
Are you willing to volunteer time for St. Peter's ministries:YesNoMaybe
Please name any talents or skills you can offer:
Liturgical involvement or interest:Eucharistic MinisterLectorHospitalityMusicianSacristan (set up worship space)
Are you interested in being contacted regarding the following?AnnulmentAdult ConfirmationRCIA (Becoming CatholicOther
Please specify:
Add Member of Household
1)
Name:
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