Permanent Diaconate Inquirer Information
www.dio.org/diaconate
Your Information
Full Name
*
Birth Date
*
Pastor's Name
*
Parish
*
Years as practicing Catholic
*
Marital Status
*
Single
Married
Divorced
Widower
Years married
*
US Citizen
*
Yes
No
Contact Information
E-mail Address
*
Home Phone
*
Cell Phone
*
Mailing Address
*
City
*
Zip Code
*
Wife's Contact Information
Name
E-Mail
Phone
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