Confirmation Registration Form

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This field is for validation purposes and should be left unchanged.

Confirmand’s Name

First Middle Last

Date of Birth

Date of Baptism (optional)

Church, City and State of Baptism

What grade is the Confirmand in?

Has Confirmand received First Eucharist?

Confirmand’s Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent 1 Name

Parent 1 Email

Parent 1 Phone

Parent 2 Name

Parent 2 Email

Parent 2 Phone