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Family Name:*
Father's Name:
Mother's Name:
Child's Name:*
Gender:*
 Male
 Female
Applying for Grade:*
Child's Birthdate
Phone #:*
E-Mail:*
Address:
Do you have a home church?
 Yes
 No
Has your child been baptized?
 Yes
 No
Last School Attended:
Questions or Comments:


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