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Last Name (Apellido)
First Name (Nombre)
Street or Route (Calle)
Home Phone (Teléfono)
Email (Correo Electrónico)
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Single (Soltero)
Married (Casado)
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Zip
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Husband (Esposo)
Name (Nombre)
Date & Place of Birth (Fecha y ciudad de Nacimiento)
Place of Baptism (Iglesia de Bautizo y Fecha)
First Communion Date (Fecha de Primera Comunión)
Confirmation Date (Fecha de Confirmación)
Place & Date of Marriage (Ciudad (O Iglesia) de Matrimonio)
Occupation (Ocupación)
Business Phone (Teléfono de Negocios)
Religion (Religión)
Wife (Esposa)
Wife's Maiden Name (Nombre de Esposa)
Date & Place of Birth (Fecha y ciudad de Nacimiento)
Place of Baptism (Iglesia de Bautizo y Fecha)
First Communion Date (Fecha de Primera Comunión)
Confirmation Date (Fecha de Confirmación)
Place & Date of Marriage (Ciudad (O Iglesia) de Matrimonio)
Occupation (Ocupación)
Business Phone (Teléfono de Negocios)
Religion (Religión)
Add Children (Agregar Niños)
Add Children (Agregar Niños)
Child 1 (Niño 1)
Name (Nombre)
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Gender
Date of Birth
Month
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Month
Day
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Year
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Add another child (Agregar otro niños)
Child 2 (Niño 2)
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Feb
Mar
Apr
May
Jun
Jul
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Day
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Day
Year
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1955
1956
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1963
1964
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Year
Age (Edad)
Grade (Grado)
Add another child (Agregar otro niños)
Add another child (Agregar otro niños)
Child 3 (Niño 3)
Name (Nombre)
Male
Female
Gender
Date of Birth
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Year
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Year
Age (Edad)
Grade (Grado)
Add another child (Agregar otro niños)
Add another child (Agregar otro niños)
Child 4 (Niño 4)
Name (Nombre)
Male
Female
Gender
Date of Birth
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Year
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Year
Age (Edad)
Grade (Grado)
Add another child (Agregar otro niños)
Add another child (Agregar otro niños)
Child 5 (Niño 5)
Name (Nombre)
Male
Female
Gender
Date of Birth
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Year
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Year
Age (Edad)
Grade (Grado)
Add another child (Agregar otro niños)
Add another child (Agregar otro niños)
Child 6 (Niño 6)
Name (Nombre)
Male
Female
Gender
Date of Birth
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Year
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Year
Age (Edad)
Grade (Grado)
Add another child (Agregar otro niños)
Add another child (Agregar otro niños)
Child 7 (Niño 7)
Name (Nombre)
Male
Female
Gender
Date of Birth
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Year
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Year
Age (Edad)
May we contact someone in your household? (Podemos contactar a alguien en su hogar?
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