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Name of Teacher: ____________________________Date Rec’d: __________________Initial of Last Name: ___________

Our Lady of Mount Carmel Church


First Holy Communion Registration Form

Student’s Full Name: ____________________________________________________________________


First Middle Last

Father’s Full Name: _____________________________________________________________________


First Middle Last

Mother’s Full Name: ____________________________________________________________________


First Middle (Maiden) Last

Other Guardian Informatin: _______________________________________________________________

Address: ______________________________________________________________________________
Street City Zip Code

Home Phone: ___________________________ Business Phone: _________________________

Cell Phone: _____________________________ E-mail Address: __________________________

Age: __________ Gender: □ Male □ Female

Date of Birth: _____/______/__________ Date of Baptism: _____/______/__________

Place of Birth: __________________________________________________________________________


City State Country

Church of Baptism: _______________________________________________________________________

Address: ________________________________________________________________________________
Street City Zip Code

_________________________________________________________________________
State Country

If Baptism was in the Archdiocese for the Military Services, what is the record number? _______________

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FOR OFFICE USE ONLY

Copy of Baptismal Certificate Workshop #2


Parish Registration Form Date of Reconciliation
Permission Letter from Pastor Workshop #3
Workshop #1 Workshop #4
Notes: _______________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________

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