St. John the Apostle Catholic Parish

Virginia Beach, VA

Online Sacramental Record Request Form

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  Today's Date REQUIRED Please fill out this field. Please enter a date.
  
  Full Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.
  
  Maiden Name, if married. Please enter valid data.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  
  City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Father Please enter valid data.
  
  Name of Mother Please enter valid data.
  
  Mother's Maiden Name Please enter valid data.
  
  Date or approximate date of the Sacrament Please enter valid data.
  
  Name of the Church where official document can be sent REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing address of Church 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 of Church REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email of Church where official document can be sent Please enter an email address.
  
  Your primary email for communication REQUIRED Please fill out this field. Please enter an email address.
  
  Your primary phone number for communication REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
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