St. Jerome Parish

Roman Catholic Church

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First Reconciliation/Eucharist Online Registration

- Sacraments

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- FIRST RECONCILIATION/EUCHARIST ONLINE REGISTRATION
- Candidate's Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
- Postal Code REQUIRED Please fill out this field. Please enter valid data.
- Telephone REQUIRED Please fill out this field. Please enter valid data.
- School Attending REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Candidate's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Candidate's Place of Birth REQUIRED Please fill out this field. Please enter valid data.
- Candidate's Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- City of Church where Baptism took place REQUIRED Please fill out this field. Please enter valid data.
- Candidate's Father REQUIRED Please fill out this field. Please enter valid data.
- Candidate's Mother REQUIRED Please fill out this field. Please enter valid data.
- Primary Email for Contact: REQUIRED Please fill out this field. Please enter valid data.
- Are you and your family registered parishioners of St. Jerome's? REQUIRED Yes No Please fill out this field.
- If No, to what parish do you belong? Please enter valid data.
- I AM AWARE OF THE FOLLOWING: REQUIRED
  If the candidate has NOT been baptized at St. Jerome Parish, a copy of the candidate's baptismal certificate MUST be provided. If this is not possible, you must contact the parish office.
  Yes Please fill out this field.
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