Permanent Record Form for Deacons

Thank you!

Ordaining Prelate

Baptismal Place *

Elementary School Attended (name and location) *

High School Attended (name and location) *

College Attended (name and location) *

Post Graduate Work/Degrees

Marriage Date and Place *

Primary Employment Career(s) *

Ordination Place and Date *

Baptismal Date *

Present Citizenship *

Date if Naturalized

Ordained for what Diocese *

If incardinated into this Diocese after being excardinated elsewhere, Date

If not incardinated in this diocese, Date of Arrival

Most recent date of Diaconal Faculties Granted in Diocese of Salt Lake City

Assignments Since Ordination *Please list all your assignments, including the start date and end date if applicable

Headshot Photo *

Name Deacon goes by: *

Social Security Number: *

Home Phone

Work Phone

Cell Phone

Email Address *

Wife’s Phone

Wife's Email

Full legal name: *

Headshot Photo with Spouse

Current Address *

Wife’s full legal maiden name

Children’s names and birth years

Father’s Name: *

Mother’s Maiden Name *

Birth Date *

Please leave this blank. It's here to fool robots.