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Northeast Nebraska Catholic Engaged Encounter
General Info
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Register For Your Weekend
DO NOT WRITE IN THIS BOX!
Select Your Weekend
Engaged Encounter Weekend
Choose a weekend…
3/24/2012 - 3/25/2012 (Norfolk, NE)
7/28/2012 - 7/29/2012 (Norfolk, NE)
9/22/2012 - 9/23/2012 (Norfolk, NE)
1/19/2013 - 1/20/2013 (Norfolk, NE)
3/16/2013 - 3/17/2013 (Norfolk, NE)
7/20/2013 - 7/21/2013 (Norfolk, NE)
9/21/2013 - 9/22/2013 (Norfolk, NE)
Couple Information
Groom
Bride
First Name
*
Last Name
*
Address
*
City
*
State
*
Zip Code
*
Phone #
*
E-mail
*
Birthdate
*
/
/
/
/
Religion
*
Parish
*
Occupation
*
Parent's Address
*
Parent's City
*
Parent's State
*
Parent's Zip Code
*
Parent's Phone #
*
Additional Information
Wedding Date
*
/
/
Church Name
*
Priest Marrying You
*
Referred By
*
Special Needs
Diet
Handicap
Medical
Notes:
Please explain any special needs
Register