Request for a Communion/Confirmation Certificate

Request for a Communion/Confirmation Certificate

Please use this form to request a copy of a your Communion or Confirmation Certificate. Pleased use a separate form if you are requesting BOTH a communion and confirmation certificate! Provide any information you have to assist us in finding the requested record. (An individual must have received communion or confirmation at Our Lady of Lourdes for a certificate to be prepared)
I am requesting a certificate of my
Approximate date of Communion/Confirmation

MonthDayYear
Date
Name of person who received Communion/Confirmation at Our Lady of Lourdes

First NameLast Name
Name of person requesting certificate

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How would you wish to receive the certificate?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your voluntary $10 donation to Our Lady of Lourdes will help defray costs of processing and sending your certificate. We thank you for your kindness in supporting the work and ministry of Our Lady of Lourdes.

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