St. Anne Church 2000 Kay Circle, Columbus, GA 31907 Phone: (706) 561-8678 Fax: (706) 565-4845
Family Information Family Name: * Street Address: * Mailing Address: (If Different) City: * State: * Zip Code: * Home Phone: * Unlisted? Email Address: * Marital Status: * Please Select Single Married Widowed Separated Divorced Annulled Date Of Marriage: Adult Information Your Information Title: * None Mr. Mrs. Miss Ms. First Name: * Middle Name: * Last Name: * Goes By: * Date of Birth: * Gender: * Female Male Religion: * Date Joined Parish: * Occupation: * Employed By: * Work Phone: * Email: * Spouse's Information Title: None Mr. Mrs. Miss Ms. First Name: Middle Name: Last Name: Goes By: Date of Birth: Gender: Female Male Religion: Date Joined Parish: Occupation: Employed By: Work Phone: Email: Children Under 21 Child 1 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Child 2 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Child 3 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Child 4 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Child 5 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Child 6 First Name: Middle Name: Last Name: Gender: Female Male Date of Birth: Religion: Baptized: Yes No Email: Misc. Where are you from? Are any non-Catholic members of your household interested in instructions in the Catholic faith? Who? Is anyone in your household in a nursing home? Who? Where? Is anyone in your household unable to get to church that would like to receive Holy Communion at home? Who? Indicate if you do not want your person information listed in parish publication. Name Address Phone Email *= Required Field
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