| GENERAL INFORMATION |
| First Name: M.I. |
Last Name: |
| Email: |
Age: |
| Present Address: |
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| City: |
State: |
Zip: |
| Permanent Address: |
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| City: |
State: |
Zip: |
| Phone (H): |
Phone (W): |
| Date of Birth: dd/mm/yyyy |
Place of Birth: |
| Year of Baptism: |
Parish of Baptism: |
| Are you a Roman Catholic Yes No |
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| Current Pastor: |
Present Parish: |
| Father's Name: |
Religion: |
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Living? Yes No |
Year of Death: |
| Mother's Maiden Name: |
Religion: |
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Living? Yes No |
Year of Death: |
| Parents' Marital Status: |
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| Number of Sisters: |
Number of Brothers: |
Rank in Family: |
| Father's Position or Business: |
Mother's Position or Business: |
| Have you ever been married? Yes No |
Do you have any children? Yes No |
| Are you responsible for the financial support of any other person? Yes No |
| Are you involved in any lawsuits or other legal proceedings? Yes No |
| Have you ever been arrested or charged with a crime? Yes No |
| If yes, please explain: |
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| HEALTH |
| Height: |
Weight: |
Eyesight: |
Hearing: |
| Is your health as good as that of most people? Yes No |
| Specify any physical or psychological infirmities: |
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| Do you smoke? Yes No |
| Specify any past or present addictions: |
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| EDUCATION |
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| Have you ever studied for a diocese, or been a candidate for a religious community? Yes No |
| If yes, please specify where and when: |
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| WORK EXPERIENCE |
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| In the space below, indicate what influenced you to seek the monastic life: |
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| What do you expect from the monastic life? |
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