Please tell us about yourself.
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Your name:
* Email:
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Age
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Occupation
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No. of years
as a Catholic:
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How often do you attend Mass?
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Do you have debt?
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Have you ever been married?
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Do you have any children? If so, list names and ages. Otherwise, enter "none."
What other devotions do you regularly practice?
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Tell us about your education and experience.
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What parish or diocesan activities do you participate in?
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Do you have any medical conditions, illnesses, or physical challenges?
Please tell us  the name of your parish priest.
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May we contact him? (Please provide e-mail address or phone number & best time to contact.)
Do you have any questions for us?
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