St Agnes Confirmation registration
2019/2020
First Name *
as it will show on their Confirmation certificate
Your answer
Middle Name
as it will show on their Confirmation certificate
Your answer
Last Name *
as it will show on their Confirmation certificate
Your answer
Gender *
School attending *
Teacher's name *
Parish family is registered at *
**If registered at a parish other than St Agnes, please obtain a letter from the parish priest with permission to have their Confirmation with their classmates. This letter will be handed in at the enrollment ceremony.**
If you are a parishioner at St. Agnes please state your envelope number
Your answer
Father's/Guardian's E-mail *
Your answer
Mother's/Guardian's E-mail *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Date Child was Baptized *
**bring a copy of the baptism certificate to the enrollment ceremony**
MM
/
DD
/
YYYY
Where child was Baptized *
**bring a copy of the baptism certificate to the enrollment ceremony**
City where child was Baptized *
**bring a copy of the baptism certificate to the enrollment ceremony**
Address where child was Baptized if not in K/W
Your answer
Where child had First Reconciliation *
Year child had First Reconciliation *
Your answer
Father's/Guardian's First & Last Name(s) *
Your answer
Father's religion *
Father's/Guardian'sAddress *
Your answer
City *
Your answer
Postal Code *
Your answer
Father's/Guardian's Home Phone *
Your answer
Father's/Guardian's Cell Phone
Your answer
Mother's/Guardian's first & last name *
Your answer
Mother's maiden name *
Your answer
Mother's religion *
Mother's/Guardian'sAddress *
Your answer
City *
Your answer
Postal Code *
Your answer
Mother's/Guardian's Home Phone *
Your answer
Mother's/Guardian's Cell Phone
Your answer
Special family circumstances
Your answer
Additional notes
Your answer
Registrations and paperwork must be completed by November 1st. If it is after this date please call the parish for a meeting with Father Aleks.
Your answer
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