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Church Contact Information UPDATE Form

- OUR PARISH

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- CHURCH NOTIFICATION FORM
  
  Immaculate Conception Catholic Church uses an internet-based notification system called Blackboard to send texts, emails, and voice calls to parishioners regarding CHURCH activities, events, etc. as needed.
  
  If you are NOT receiving notifications and would like to be added to the notification system, OR if any of your contact information has changed, please complete the information below. If you have questions, please call Jamie in the PREP office at 337-625-9719.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address 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.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Church Parish Information REQUIRED I am a registered member of Immaculate Conception Catholic Church, Sulphur. I am NOT a member of Immaculate Conception Catholic Church but would like receive notifications. Please fill out this field.
  
  Reason for Submission REQUIRED Please fill out this field.
  
  Select all information to be updated. REQUIRED Name Address Phone Number Email Please fill out this field.
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