Personal Information
Mailing Address
If you selected "No" please fill out your mailing address
Members of the Family
Please list the parents of the household, and all dependent children living at home in the following format:
First name, Last name, (Male or Female), Member of Family, Date of Birth, Current Religion
Example:
John, Doe, Male, Father, 11/03/75, Catholic
Jane, Doe, Female, Mother, 03/04/77, Catholic
Phil, Doe, Male, Son, 04/06/11,
Sally, Doe, Female, Daughter, 10/15/01, Catholic
Martial Status
Offering Envelopes
Other Information
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510 Narragansett AveEast Patchogue, NY631-286-9133
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