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First Communion
Block
Base Price: $15.50
Qty
Name of
Communicant
First Name
Middle Name(s)
Last Name
Date of
Communion
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January
February
March
April
May
June
July
August
September
October
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Month
Day
Year
Time of
Communion
Hour
Minute
AM
PM
N/A
Church
City & State
City
State/Providence
A Special Gift From
Optional ($1.50)
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