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- Art Suriano Music
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Registration Form

* Indicates required field

Family's last name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Cell Phone Number *

Choose any of the following *

I have someone at home who wishes to receive Holy Communion. Option I have an issues that I would like to discuss with the priest.2 N/A

Family members

Family member 1 (adult) *

First

Last

Gender *

Male Female N/A

D.O.B. example: 10/03/1985 *

Sacraments Received *

Baptism First Communion Confirmation

Occupation/Hobbies *

Family Member 2 (adult) (optional) *

First

Last

Choose One *

Male Female N/A

D.O.B. example: 10/03/1985 *

Sacraments Received *

Baptism First Communion Confirmation

Occupation/Hobbies *

Children

(if none, scroll to bottom and select "register now")

Child #1 (optional) *

First

Last

Chose one *

Male Female N/A

D.O.B. example: 10/03/1985 *

Sacraments Received *

Baptism First Communion Confirmation

Child #2 (optional) *

First

Last

Choose One *

Male Female N/A

D.O.B. example: 10/03/1985 *

Sacraments Received *

Baptism First Communion Confirmation

Child #3 (optional) *

First

Last

Choose One *

Male Female N/A

D.O.B. example: 10/03/1985 *

Sacraments Received *

Baptism First Communion Confirmation

Submit

(to add additional children, please select "register now" and submit a second form.)

Location

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Home
About
What's Happening
Music Ministry
- Art Suriano Music
Amazon Smile Program