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Sacrament Certificate Request

- Sacraments

Sacrament Certificate Request
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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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Email Confirmation REQUIRED Please fill out this field. Please enter an email address.
- Certificate Donation: $10 REQUIRED Give over Phone: (661)323-3108 Give Online: Click Button Below Please fill out this field.
- Sacrament Certificate Request
- Estimated Date Sacrament Received REQUIRED Please fill out this field. Please enter a date.
- Name on Certificate REQUIRED Please fill out this field. Please enter valid data.
- Father: First & Last Name REQUIRED Please fill out this field. Please enter valid data.
- Mother: First & Last Name(Maiden Name) REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Reason for Request REQUIRED
  Example: I need X,Y, Z certificatea in order to become a godparent.
  Please fill out this field.
- Certificate Pick-Up REQUIRED In Office Pick-up: Please bring Valid ID Mail: Church in need of Certificate, address below. Please fill out this field.
- Mail Certificate: Church in need of Certificate
  Name of Church & Address
Submit

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