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Couple's Information

Wife's Name
(first) (last)
Wife's Denomination
Husband's Name
(first) (last)
Husband's Denomination
Street Address:
City, State,Zip
Home Phone: () -
E-mail:
Please Select a parish in LA County. If you are from Orange or San Diego County then select "Diocese of Orange" or "Diocese of San Diego". All others please choose "other unlisted location" at the bottom of the list.
Parish
Way You'd like to Help
Additional Information that You Feel may be Helpful:

 

 

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