Shepherd of the Hills Confirmand Intake Form
Please fill out completely. The information provided will be printed on the child's Confirmation Certificate
Child's Full Name
*
First Name
Middle Name
Last Name
Child's Date of Birth
-
Month
-
Day
Year
Date
Selected Verse
Example: John 3:16
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
*
-
Area Code
Phone Number
Contact Email
*
example@example.com
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