How do you wish to connect to St Columba's?
*
(Check all that apply)
If transferring, please list the name and city/state of the parish/church from which you're transferring.
Name
*
First Name
Last Name
Email
*
Cell Phone
*
(###)
###
####
Date of Birth
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Anniversary Date
MM
DD
YYYY
Baptized?
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If baptized, please list parish and date (if exact date isn't known, list the approximate year)
Confirmed?
If confirmed, parish/date (approximate year, if exact date is not known)
Spouse's Name
First Name
Last Name
Spouse Cell Phone
(###)
###
####
Spouse Email
Spouse Date of Birth
MM
DD
YYYY
Baptized?
If baptized, parish/date (approximate year, if exact date is not known)
Confirmed?
If confirmed, parish/date (approximate year, if exact date is not known)
Child 1
First Name
Last Name
Child 1 Date of Birth
MM
DD
YYYY
1) Baptism & Confirmation Information
1) If baptized and/or confirmed, please list dates and name of parish (city, state). Approximate year, if exact dates are not known.
Child 2
First Name
Last Name
Child 2 Date of Birth
MM
DD
YYYY
2) Baptism & Confirmation Information
2) If baptized and/or confirmed, please list dates and name of parish (city, state). Approximate year, if exact dates are not known.
Child 3
First Name
Last Name
Child 3 Date of Birth
MM
DD
YYYY
3) Baptism & Confirmation Information
3) If baptized and/or confirmed, please list dates and name of parish (city, state). Approximate year, if exact dates are not known.
Child 4
First Name
Last Name
Child 4 Date of Birth
MM
DD
YYYY
4) Baptism & Confirmation Information
4) If baptized and/or confirmed, please list dates and name of parish (city, state). Approximate year, if exact dates are not known.
I am (we are) interested in learning more about these ministries:
(check all that apply)
