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Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address REQUIRED Please fill out this field. Please enter valid data.

Subdivision or Apartment Complex REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Primary 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.

Are you currently Registered at another parish in the Austin Diocese? REQUIRED Yes No Please fill out this field.

If yes, which one? Please enter valid data.

Head of Household #1

Name REQUIRED Please fill out this field. Please enter valid data.

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

Gender REQUIRED Male Female Please fill out this field.

Religion REQUIRED Please fill out this field. Please enter valid data.

Marital Status REQUIRED Married Single Divorced/Separated Widowed Please fill out this field.

If Married-Name of Church, Celebrant, and date of wedding Please enter valid data.

Occupation and Employer REQUIRED Please fill out this field. Please enter valid data.

Head of Household #2

Name Please enter valid data.

Date of Birth Please enter valid data.

Gender Male Female

Religion Please enter valid data.

Occupation and Employer Please enter valid data.

Email if different from above Please enter valid data.

Phone number if different from above Please enter valid data.

Please indicate which option you choose for your contribution to the Church. REQUIRED Weekly Offering (52 Sunday Envelopes) Monthly Offering (1 Sunday Envelope) Electronic Giving Please fill out this field.

Names of Children (under the age of 24, if living at home)

First and last name of child # 1 Please enter valid data.

Date of Birth Please enter valid data.

Gender Male Female

School Grade Please enter valid data.

First and last name of child # 2 Please enter valid data.

Date of Birth Please enter valid data.

Gender Male Female

School Grade Please enter valid data.

First and last name of child #3 Please enter valid data.

Date of Birth Please enter valid data.

Gender Male Female

School Grade Please enter valid data.

If more than three (3) children contact the receptionist at [email protected] or 512-218-1183.

St. John Vianney

Catholic Church

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