Holy Cross Church

Bronx, New York

Registration Form

- Religious Ed.
  - Information - Información
  - Registration Form - formulario de Inscripción

2017-18 Religious Education Registration Form
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name 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.
- 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.
- Age / Edad Please enter valid data.
- School Grade / Grado Escolar Please enter valid data.
- Father Name / Nombre del Padre Please enter valid data.
- Mother Maiden Name / Nombre de la Madre Please enter valid data.
- Sacraments received / Sacramentos Recibidos Baptism / Bautismo Reconciliation / Reconciliación First Communion / Primera Comunión Confirmation / Confirmación Matrimony / Matrimonio
- Additional Notes / Notas Adicionales
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