85 South Maple St., PO Box 324
Vergennes, VT 05491
P: (802) 877.2367   F:

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Parish Registration Form
The information requested on this form includes all the data that is listed in our parish records. Names and contact information are necessary. All other information may be supplied or withheld at your discretion.
Family Name:

Phone Number:
Street Address:

Mailing Address:

City:     State:     Zip:
Email Address:
Language Spoken at Home:
Family Residence:
Marriage Status:
(If Married) by:
Date of Marriaged:
Mass Attendance:
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Full Name
Including Maiden Name
Date of BirthCountry of BirthReligionSacraments
Location (church, city & state)
School and Grade/Occupation and Business Phone
Husband:



Baptism:
First Communion:
Confirmation:

Wife:



Baptism:
First Communion:
Confirmation:

Child:



Baptism:
First Communion:
Confirmation:

Child:



Baptism:
First Communion:
Confirmation:

Child:



Baptism:
First Communion:
Confirmation:

Child:



Baptism:
First Communion:
Confirmation:

Child:



Baptism:
First Communion:
Confirmation:

Other:(Add Relation)



Baptism:
First Communion:
Confirmation:

Other:(Add Relation)



Baptism:
First Communion:
Confirmation:



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Also enter your family name again here: --



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