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Personal Information
Title:   *First Name: Initial:    *Last Name: 
*Address:    Apt #: 
*City:    *State:    *Zip: 
*Home Phone:    Fax:    *Email: 
Marital Status
 Date of Marriage:    Married by:    If Other: 
Employment Information
Husband's Employer:    Work Phone: 
Wife's Employer:    Work Phone: 
Religious Information
Family Name
List each household member		 Date of Birth Religion Baptized
(month/yr)		 First Communion
(month/yr)		 Confirmation
(month/yr)

Contribution Information
Amount:   
Please Check Your Interests:
    Minister of Holy
           Communion		   Lector Usher    Music/Choir    Altar Server
   Parish School of
          Religion		    Altar Society    St. Vincent de Paul    Outreach Ministry    Hospitality/Committee
   Pastoral Council    Finance Council    Knights of Columbus    Liturgy    Social Concern
   11 am Nursery    Vocations    Parish Life    Other (specify in the comment section below)
Comments and/or Special Needs

Thank you for registering at St. John Berchmans Cathedral.