Confirmation Registration

Parish Family's Registration#:

Is this your First Year Preparation?:YesNo

Last Name:

First Name:

Date of Birth:

Age:

School Name:

Grade:

Address:

City:

State:

Zipcode:

Phone:

Work:

Cell:

Emergency Contact

Last Name:

First Name:

Phone

Home:

Cell:

Are you baptized:YesNo

Church's Name:

City:

State:

County:

Father's Name

Last:

First:

Mothers's Name

Last:

First:

Languages that you speak:EnglishSpanish Other:

What language do you prefer to receive your Confirmation class?:

What is your primary motivation to be prepared for the Sacrament of Confirmation?:

Are you willing to follow and assume the rules, assignments, projects of this sacramental journey?

Are you willing to participate every Sunday at Mass?:

Special Notes: