Nominee'S Information Form - Personal Information

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N
’
F
OMINEE
S INFORMATION
ORM
PERSONAL INFORMATION
Name
_______________________________________________________________________________
Present Address
_______________________________________________________________________________
City/State/Zip
_______________________________________________________________________________
Phone
_______________________________________________________________________________
Cell Phone
_______________________________________________________________________________
Permanent Address
_______________________________________________________________________________
(if different from above)
Phone-Permanent Address
_______________________________________________________________________________
E-mail Address
_______________________________________________________________________________
Gender
Male
Female
Birth Date
_____/ __ /19___
Birthplace (City/State)
_______________________________________________________________________________
Communicant of
_______________________________________________________________________________
Length of Residency in Diocese
____________________________________________________________________________
Date of Baptism
_______________________________________________________________________________
Performed by
_______________________________________________________________________________
Date of Confirmation or Reception into the Episcopal Church
__________________________________________________
Performed by
_______________________________________________________________________________
Have you previously applied for postulancy? If so, when and briefly describe resulting action.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
M
STATUS
ARRITAL
Current marital status (please circle)
Single
Married
Separated
Divorced
Widowed
If married, spouse's name
____________________________________________________________________________
If married, length of marriage
____________________________________________________________________________
If previously married, length of marriage (s)
_________________________________________________________________
Write a brief evaluation of your spouse's feelings regarding your intent to enter the priesthood:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
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