High School Confirmation Registration Form

Registration Form

*=Required

Enter the FULL name of the Confirmation Candidate. *

Enter the home address of the Confirmation Candidate. *

Enter the home phone number of the Confirmation Candidate. *

Enter the e-mail address of the Confirmation candidate.

Enter the Confirmation candidate's birth date. *

Enter the grade of the Confirmation Candidate in 2011-2012. *

Enter the name of the school in which the Confirmation Candidate is enrolled. *

Enter the name of the Confirmation Candidate's mother (with Maiden name in parenthesis). *

Enter mother's e-mail address.

Enter mother's cell phone number.

Enter the name of the Confirmation candidate's father.

Enter father's e-mail address.

Enter father's cell phone number.

When and where was Confirmation candidate last involved in religious education? *

In the candidates own words, please define Confirmation. *

Is Confirmation Candidate's family registered as members of St. Augustine Church? *

	Yes
	No