If husband and wife listed above were married in a Catholic Church, please put the date of the wedding (MM/DD/YYYY):
Nationality:
If anyone listed above is not Catholic, please list their name and religious affiliation:
Full Name: Religious Affiliation:
If anyone above is homebound, please list the name(s) below with comma after each name:
Click the SUBMIT button when you are finished or click CLEAR to start again.
If you have difficulty sending this form, please print it and mail or fax it to us at:
The Holy Family Church 28 Brookline Avenue Nutley, New Jersey 07710 Fax# 973-661-1714
All information will be kept strictly confidential.
