Holy Communion Registration Form

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Name

This field is for validation purposes and should be left unchanged.

Student's Full Name(Required)

First Last

Date of Birth(Required)

Place of Birth(Required)

Date of Baptism (baptism certificate required)(Required)

Place of Baptism (Church, City and State)(Required)

Is this a Roman Catholic Church?(Required)

Godparents' Names(Required)

Are you a registered member of JGS Church?(Required)

Father's Full Name(Required)

Mother's Full Name (including Maiden Name)(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Phone #(Required)

Alternate Phone #(Required)

Parent E-mail(Required)