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2022-2023 Confirmation WAITING LIST Information Form
THIS IS NOT A REGISTRATION FORM.
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I understand that this form is A WAITING LIST to register for the Confirmation Program at Our Lady of Perpetual Help in Selma, TX and I will be notified by mid-September whether or not more spots are available.
*
Yes, I Understand.
TEEN CANDIDATE INFO
Please ensure that all information is correct before submitting!
MarcetteTeen's FIRST Name
*
Your answer
Teen's LAST Name
*
Your answer
TEEN (NOT PARENT) Cell Phone (for online assignments)
*
Your answer
Gender
*
Choose
Female
Male
Birthday
*
MM
/
DD
/
YYYY
Grade
*
Choose
9th
10th
11th
12th
School
*
Your answer
Teen lives with: (check all that apply)
*
Mom
Dad
Stepmom
Stepdad
Other:
Required
PARENT/GUARDIAN INFO
Please ensure that all information is correct before submitting. Should ANY information change while your teen is in our program, please let us know!
Both Parents/Guardian's Names
*
Your answer
The Parent/Guardian serving as Primary Contact
*
Your answer
Primary Contact Cell Phone
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Please enter 10-digit number
Your answer
Primary Contact Email
*
Your answer
Mailing STREET Address
*
Your answer
City & ZIP CODE
*
Your answer
Does the candidate have reliable internet access via phone or home service?
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Yes
No
Please check all that apply:
*
The primary contact (parent/guardian) only speaks Spanish.
Candidate also needs 1st Communion & 1st Reconciliation
None of the above
Required
IMPORTANT: I understand that IF SPACES ARE AVAILABLE, I will need to submit a copy of my teens BAPTISMAL CERTIFICATE upon final registration or they will not be input into a class. (Even if Baptized at OLPH)
*
Yes, I Understand.
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