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Father Albert J. Todd Council 12119
   •   1005 Wilbon Rd.   •    Fuquay-Varina, NC 27526   •    www.kofc12119.org   •   

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Please submit any data changes to the Financial Secretary ASAP.
First Name
MI
Last Name
Membership Number
Address
Address Cont,
City
State
Zip
2nd Degree Date
3rd Degree Date
4th Degree Date
Phone Number
Choose Type:HomeCellWork
Alt. Phone Number
Choose Type:HomeCellWork
Email Address
Choose Location:HomeWork
Alt. Email Address
Choose Location:HomeWork
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