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St. Nicholas Catholic Church, Miller City
Holy Family Catholic Church, New Cleveland

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The maximum number of form submissions has been reached. This form is currently not available.
- We would love to connect with you! Please complete the online registration form below and a member of our staff will reach out to you shortly.
- Head of Household
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
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- Head of Household
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Request to Register with Holy Family or St. Nicholas REQUIRED Please fill out this field.
- Offertory envelopes REQUIRED
  Please let us know if you would like to receive offertory envelopes which are mailed to your home address bi monthly.
  Please fill out this field.
- Parish Ministry
- Sacraments Received REQUIRED Baptism Eucharist Confirmation Matrimony Please fill out this field.
- Number of Additional Family Members REQUIRED Please fill out this field.
  
  Family Members 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 3
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 4
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
  
  Family Members 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Eucharist Confirmation Please fill out this field.
- I Agree Please select this field.
- Email (Confirmation will be sent to this email address) REQUIRED Please fill out this field. Please enter an email address.
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