Confirmation Registration 2019/2020
Student's Full Name *
Your answer
Student's Email Address *
Your answer
Birth Date *
MM
/
DD
/
YYYY
School Attending *
Your answer
Grade *
Student's Phone Number
Your answer
Date of Student's Baptism
MM
/
DD
/
YYYY
Parent or Guardian #1 Name *
Your answer
Phone # *
Your answer
Address *
Your answer
Preferred Email Address *
Your answer
Parent or Guardian #2 Name
Your answer
Phone #
Your answer
Address if Different from Above
Your answer
Email Address
Your answer
Has your student received instruction for Holy Communion? *
Allergies or Other Health Information?
Your answer
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