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Little Flower Parish
Little Flower School
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Your Information
Family Last Name
Email
Phone
Cell Phone
Address
Address
City
State
Zip
Head of Household
First Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Married
Yes
No
Children?
Yes
No
Marriage Recognized by the Catholic Church
Yes
No
Education
HS
Assoc. Degree
Bach.
Masters
Ph.D.
Professional
Occupation
Spouse
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Education
HS
Assoc. Degree
Bach.
Masters
Ph.D.
Professional
Occupation
Child
Child Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Child 2
Child 2 Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Child 3
Child 3 Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Child 4
Child 4 Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Rarely
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Child 5
Child 5 Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Yearly
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Child 6
Child 6 Name
Baptized
Yes
No
Confirmed
Yes
No
Birth Date
Attend Mass
Daily
Weekly
Monthly
Yearly
Education
LF
Other Catholic
Public
Private
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Special Needs
Interest in becoming a Catholic
Yes
No
Interest in receiving the Eucharist at home
Yes
No
In need of assistance with household errands
Yes
No
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