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RECEPTION REPORT
DIOCESE OF DALLAS ,20(Date of Service)
The Right Reverend (Officiating Bishop)
Reverend Father in God, I present to you these personswho have previously received the Sacramentof Confinnation, and who desire to be Received into this Communion: (Signed) Rector or Minister in Charge of
in the City/Town of
No.
Carbonlesspaper,pleaseretain copyfor your file.
FULL NAME:
Church ,
Dioceseof Dallas Previous religious connection
AGE:
