Confirmation and Peer Ministry Registration
2018-2019
We ask each family to donate $30 toward the expenses of our program with one family donating no more than $50. Our expenses rise each year and we work hard to keep these down. Money should never be a factor in a young person’s participation and scholarships are available if needed. Please talk to one of the pastors if this is an issue for you. Please bring donation to the office or to the orientation night, Wednesday September 12th at 6:45pm.
Email address *
Student's Name *
(Last, First)
Your answer
Grade for 2018-2019 *
Date of Birth (mm/dd/yyyy) *
Your answer
Date of Baptism
(If unknown please try to find records)
Your answer
Baptismal Congregation
(Where student was baptized, please include town)
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Mailing Address *
Your answer
Parent/Guardian Email Address *
Your answer
Parent/Guardian Phone *
(Please use the phone where you can be reached most easily)
Your answer
Are there any concerns of which we should be aware?
(Allergies, learning disabilities, etc.)
Your answer
Adult Volunteer Opportunities *
Required
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This form was created inside of Holmen Lutheran Church.