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Parish Registration
Family Last Name
Registration Date
MM slash DD slash YYYY
Address
Street Address
City
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Virginia
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Head of Household
First Name
Occupation
Phone
Email
Spouse
First Name
Occupation
Phone
Email
Household Members – Adults
Please fill out the information below for each household member.
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add Another Adult?
Yes
No
Household Members – Adults
Please fill out the information below for each household member.
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add Another Adult?
Yes
No
Household Members – Adults
Please fill out the information below for each household member.
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Household Members – Children
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add another child?
Yes
No
Household Members – Children
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add another child?
Yes
No
Household Members – Children
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add another child?
Yes
No
Household Members – Children
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
Add another child?
Yes
No
Household Members – Children
Name
First
Marital Status
Sex
Date of Birth
MM slash DD slash YYYY
Religion
Languages Spoken at Home
Name of School, Current Grade
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