St Patrick Catholic Church

• St. Patrick's Catholic Church - Independence, OR

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  • Nombre del niño:

  • Name of Child REQUIRED

    Nombre del niño

    Please fill out this field. Please enter valid data.
  • Date of Birth REQUIRED

    Fecha de nacimiento

    Please fill out this field. Please enter a date.
  • Lugar de nacimento
  • Place of Birth
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Número de personas que asisten, incluyéndote a ti mismo
  • • Number of people attending including yourself REQUIRED
      Número de personas que asisten, incluyéndote a ti mismo
      Please fill out this field.
    • Person 1
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
      • Email REQUIRED Please fill out this field. Please enter an email address.
      • Catholic? REQUIRED (Select One) Yes No Please fill out this field.
      • Marital Status REQUIRED (Select One) Married Separated Divorced Widowed Single 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.

        State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

        Zip REQUIRED Please fill out this field. Please enter a zip code.
      • Nombre de la parroquia donde te casaste
      • Name of parish where you were married REQUIRED Please fill out this field. Please enter valid data.
      • Fecha o boda
      • Date of Wedding REQUIRED Please fill out this field. Please enter a date.
      • Comments

      • ---

        Su relación con el niño o los padres
      • Relationship to child or parents REQUIRED Please fill out this field. Please enter valid data.
    • Person 2
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
      • Email REQUIRED Please fill out this field. Please enter an email address.
      • Catholic? REQUIRED (Select One) Yes No Please fill out this field.
      • Marital Status REQUIRED (Select One) Married Separated Divorced Widowed Single 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.

        State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

        Zip REQUIRED Please fill out this field. Please enter a zip code.
      • Nombre de la parroquia donde te casaste
      • Name of parish where you were married REQUIRED Please fill out this field. Please enter valid data.
      • Fecha o boda
      • Date of Wedding REQUIRED Please fill out this field. Please enter a date.
      • Comments

      • ---

        Su relación con el niño o los padres
      • Relationship to child or parents REQUIRED Please fill out this field. Please enter valid data.
    • Person 3
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
      • Email REQUIRED Please fill out this field. Please enter an email address.
      • Catholic? REQUIRED (Select One) Yes No Please fill out this field.
      • Marital Status REQUIRED (Select One) Married Separated Divorced Widowed Single 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.

        State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

        Zip REQUIRED Please fill out this field. Please enter a zip code.
      • Nombre de la parroquia donde te casaste
      • Name of parish where you were married REQUIRED Please fill out this field. Please enter valid data.
      • Fecha o boda
      • Date of Wedding REQUIRED Please fill out this field. Please enter a date.
      • Comments

      • ---

        Su relación con el niño o los padres
      • Relationship to child or parents REQUIRED Please fill out this field. Please enter valid data.
    • Person 4
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
      • Email REQUIRED Please fill out this field. Please enter an email address.
      • Catholic? REQUIRED (Select One) Yes No Please fill out this field.
      • Marital Status REQUIRED (Select One) Married Separated Divorced Widowed Single 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.

        State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

        Zip REQUIRED Please fill out this field. Please enter a zip code.
      • Nombre de la parroquia donde te casaste
      • Name of parish where you were married REQUIRED Please fill out this field. Please enter valid data.
      • Fecha o boda
      • Date of Wedding REQUIRED Please fill out this field. Please enter a date.
      • Comments

      • ---

        Su relación con el niño o los padres
      • Relationship to child or parents REQUIRED Please fill out this field. Please enter valid data.
    • Person 5
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
      • Email REQUIRED Please fill out this field. Please enter an email address.
      • Catholic? REQUIRED (Select One) Yes No Please fill out this field.
      • Marital Status REQUIRED (Select One) Married Separated Divorced Widowed Single 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.

        State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

        Zip REQUIRED Please fill out this field. Please enter a zip code.
      • Nombre de la parroquia donde te casaste
      • Name of parish where you were married REQUIRED Please fill out this field. Please enter valid data.
      • Fecha o boda
      • Date of Wedding REQUIRED Please fill out this field. Please enter a date.
      • Comments

      • ---

        Su relación con el niño o los padres
      • Relationship to child or parents REQUIRED Please fill out this field. Please enter valid data.
  • Entiendo que San Patricio no permitirá que mi información personal se vuelva pública.
  • I understand that St. Patrick will not let my personal information become public.

    I Agree Please select this field.

  Submit

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