Registration – St. Alphonsa Cathedral Parish

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Account Info

Username *

E-mail *

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Password *

Password must be at least 7 characters long. To make it stronger, use upper and lower case letters, numbers and symbols.

Confirm Password *

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Strength Indicator

Full Name *

House Name *

Veettu paeru

Date of Birth *

Profile Picture

Spouse Details

Spouse : Full Name *

If single, mark SINGLE

Date of Birth *

Spouse - Place of Birth *

Child - 1

Name

Date of Birth

Place of Birth

Child - 2

Name

Date of Birth

Place of Birth

Child - 3

Name

Date of Birth

Place of Birth

Child - 4

Name

Date of Birth

Place of Birth

Contact Details

Address *

Suburb *

Postcode *

Mobile *

Additional mobile can be entered at the end of the form

Telephone *

If landline number is not available, please mark N/A

More Informations

Family Unit *

Diocese *

Please specify the Diocese you/your family are originally from

Contribution Number

Enter the Contribution Number assigned to your family. If none yet - please enter N/A

Kerala/India Location details *

Please specify where you/your family are originally from

Extra details

Insert any extra details like your Spouse additional EMAIL address & MOBILE number

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