Immaculate conception church

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Communion Registration Form

- How
  - How Do I...
    
    Get Involved
    Get Married
    Have a Child Baptized
    Get Confirmed
    Have a Child Receive First Communion
    
    First Communion Process & Requirements
    Communion Registration Form
    
    Go to Reconciliation

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- Candidate
  
  First Name, Middle Name, and Last Name Please enter valid data.
  
  Date of birth (month/day/year) Please enter valid data.
  
  City/state where born Please enter valid data.
  
  Date of baptism (month/day/year) Please enter valid data.
  
  Church where baptized (name/city) Please enter valid data.
  
  School where currently enrolled Please enter valid data.
  
  Current grade level Please enter valid data.
  
  School attended last year (if different) Please enter valid data.
  
  If not attending Catholic school, place where attending PSR (CCD) classes Please enter valid data.
- Family
  
  Father's Full Name Please enter valid data.
  
  Mother's Full Name Please enter valid data.
  
  Home Street Address Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Church where family is currently registered (name/city) Please enter valid data.
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