Please fill out the form below, cut and paste to an email addressed to:

Ascensionwv@cs.com

 

 

Subject:                                                                                  Date:

Mailing Address:

Name: Street:

City: State: Zip: Phone(H): Phone(W):

E-Mail Address:

Marital Status: Married, Catholic Church   Married, Other   Single

                          Divorced   Widow(er)   Separated

Registration Information:

  Father,

Male

 Mother,

Female

 Child #1 Child #2 Child #3 Child #4
First Name(s)
Last name(s)

(if different)
Religion
Occupation
Special Needs
Birth Date(--/--/--)

Sex (M or F)

Baptism (Y/N)

Penance (Y/N)

Eucharist (Y/N)

Confirmation (Y/N)

If you have additional information, please enter it below: