Registration

Name:*
Spouse Name:
Children's Name:
Address:
Date of Birth:
 / 
 / 
Telephone:
E-mail:
Place of Birth:
Spouse’s place of birth:
Spouse’s Maiden Name:
Father’s place of birth:
Mother’s place of birth:
Proof of Marriage by Applicant to be provide if requested
Referred by (existing Kastorian member):*
Referred by (existing Kastorian member):(1)*
Date:
Signature:(must be in person to sign application)

June 2024
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kastoria.us

kastoria.us