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Sacrament
Registration
For St Rose Grammar School Students
receiving at
Saint Rose Church - Belmar, NJ
Name of Child
Mailing Address
Primary Cell Phone
Primary E-mail
Date of Birth
Birth City/State
Date of Baptism (Approx)
Place of Baptism
Please include name of the church, city and state. If your child was NOT baptized at St. Rose OR did NOT make First Communion here, you must provide Baptismal Certificate.
Child's Grade
Father's Name
Religion
Mother's Name
Religion
Mother's Maiden Name
If not St. Rose, in which parish are you registered?
Current Date
Total Amount
Verification
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