Membership Form
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St. Stephen's Parish Membership form 676 Kearny Avenue, Kearny, NJ 07032 Family Name: Address: Home Phone: Former Parish:
E-mail Address:
Male Family Member: Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Female Family Member: Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Children: #1 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ #2 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ #3 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Others residing in household Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____
Office Use only: Date: __________ Registered by: __________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
E-mail Address:
Male Family Member: Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Female Family Member: Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Children: #1 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ #2 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ #3 Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Name of School: ______________________ Current Grade: __________ Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____ Others residing in household Title: __________ First Name: _________________ Last Name: Date of Birth: __________ Marital Status: _________________ Occupation: Religion: _______________ Sacraments: Baptized: _____ First Communion: _____ Confirmed: _____
Office Use only: Date: __________ Registered by: __________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
_________________ _________________
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