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St. Mary's Confirmation Registration 
Saint Mary of the Visitation Catholic Church  
52245, Iowa City, 302 East Jefferson Street
Website: icstmary.org Phone: (319) 337-4314
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First Name of Youth Confirmation Candidate *
Last Name of Youth Confirmation Candidate *
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
City *
Zip Code *
Parent/Guardian #1 Name *
Parent/Guardian #1 Email *
Parent Guardian #1 Cell Number *
Parent/Guardian #2 Name
Parent/Guardian #2 Email
Parent/Guardian #2 Cell Number
Youth Confirmation Candidate Email (no school email addresses) *
High School *
Required
Grade *
Required
Rite of Admission
On October 14th and 15th, we will introduce each candidate for Confirmation (Rite of Admission) at the Mass they normally attend with their families. 
What Mass time do you normally attend at St. Mary's *
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