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BHI Graduation 2011

1.Please enter your name as you would like it to appear on the certificate. If you do not want your middle name or initial to appear, leave that field blank.(Required.)

Name:

Parish

Address:

Address 2:

City/Town:

State:

ZIP:

Email Address:

Home Phone:

Cell Phone:

2.Current Areas of Ministry in the Church or Community(Required.)

3.Future areas of interest for Ministry in the Church or Community(Required.)