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  • Candidate's Information
    • First Name REQUIRED Please fill out this field. Please enter valid data.

      Last Name REQUIRED Please fill out this field. Please enter valid data.
    • Middle Name Please enter valid data.
    • Street Address REQUIRED Please fill out this field. Please enter valid data.
    • City REQUIRED Please fill out this field. Please enter valid data.

      State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

      Zip REQUIRED Please fill out this field. Please enter a zip code.
    • Contact Email Address REQUIRED Please fill out this field. Please enter an email address.
    • Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
    • Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
    • Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
    • Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  • Parish Membership
    • Are you a registered member of St. John Neumann Parish? REQUIRED Yes No Please fill out this field.
    • If not, in what parish are you registered? Please enter valid data.
    • Other Parish Address
  • Religious Education
    • Where does your child attend religious education? REQUIRED Please fill out this field. Please enter valid data.
    • For how many years? REQUIRED Please fill out this field. Please enter an integer (number).
  • Baptism Information
    • Date of Baptism REQUIRED Please fill out this field. Please enter a date.
    • Church of Baptism REQUIRED St. John Neumann Other Please fill out this field.
    • Name of other church Please enter valid data.
    • Address of other church

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