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Update Contact Info

- Whenever you change any aspect of your contact information it is essential to update your information with your parish. This allows us to keep our records updated so that you recieve all current information. If you need to inform us of a change to your information, please fill out the form below.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  I am still a member of St. Bernadette REQUIRED Yes No Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number (Landline) Maximum 20 characters Please enter a phone number.
  
  Phone Number (Cell) Maximum 20 characters Please enter a phone number.
  
  Street 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.
  
  Secondary Address (if applicable) Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  If you listed a second address, please explain (snowbirds, etc.) Please enter valid data.
  
  Submit
  
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