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Our Lady Queen of Martyrs

Our Lady Queen of Martyrs Registration Form
Welcome to Our Lady Queen of Martyrs. Visit our web site at www.qofm.org for more information or
 contact the parish office at 219-769-1755.
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Click Submit Form to send this information to Our Lady Queen of Martyrs.
*Required fields
*Family Option  New Family Information  Update Existing Family Information   ID/Env:  
  Call Our Lady Queen of Martyrs at (219) 769-1755, if you do not know your ID Number or Envelope Number.
Head of Household
  Title Suffix
*First Name *Last Name
  Middle Name Nickname
*Relationship Maiden Name
  Ethnicity *Birth Date
*Gender Grade/Degree
  Language *Marital Status
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible
Sacraments
  Baptism Date Place
  Reconciliation Date Place
  First Communion Date Place
  Confirmation Date Place
  Marriage Date Place
  Spouse
  Title Suffix
  First Name Last Name
  Middle Name Nickname
  Relationship Maiden Name
  Ethnicity Birth Date
Gender Grade/Degree
  Language Marital Status
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible
Sacraments
  Baptism Date Place
  Reconciliation Date Place
  First Communion Date Place
  Confirmation Date Place
  Marriage Date Place
Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP
Family Phone Numbers
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Email
*Email Unlisted
Send Email Instead of Mail When Possible
Member 1 Type
  Title Suffix
  First Name Last Name
  Middle Name Nickname
  Relationship Maiden Name
  Ethnicity Birth Date
Gender Grade/Degree
  Language Marital Status
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible
Sacraments
  Baptism Date Place
  Reconciliation Date Place
  First Communion Date Place
  Confirmation Date Place
  Marriage Date Place
Click Submit Form to send this information to Our Lady Queen of Martyrs.
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Our Lady Queen of Martyrs

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Our Lady Queen of Martyrs