2020-2021 Confirmation Registration
Last Name: *
First Name: *
Middle Name: *
Preferred Name: *
Address: *
Date of birth: *
City and state of birth: *
School: *
Grade: *
Church of baptism: (If your student was not baptized at St. Francis Xavier, please obtain a copy of the baptism certificate dated within the last 6 months. You can request a copy from the church where your child was baptized.) *
Date of baptism: *
Does your student have any allergies, medical issues or special concerns? Please explain:
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