StAgnes-Concord ADULT EDUCATION

ADULT CONFIRMATION REGISTRATION
Please submit your registration no later than December . Classes begin in January in the Ministry Center. Curriculum is attached for you to keep for your information.
Name

First NameLast Name
Birth Date:

MonthDayYear
Date
Age on date of Confirmation Must be an adult (18+)
Current Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email Address - Please print clearly in the boxes below:
example@example.com
Cell Phone:
Format: (000) 000-0000.
BAPTISM INFORMATION
Name on baptismal certificate:
Date of Baptism:

MonthDayYear
Date
Church of Baptism:
The complete address of the church of Baptism must be provided.
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
FIRST EUCHARIST INFORMATION
Church of First Eucharist:
Date of First Eucharist:

MonthDayYear
Date
The complete address of the church of First Eucharist must be provided.
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PARENT & SPONSOR INFORMATION
Father's First Name:

First NameLast Name
Mother's First Name:

First NameLast Name
Confirmation Sponsor Name:
A confirmation sponsor must be a fully initiated practicing Catholic in good standing and at least 18 years of age. He/She may not be the candidate's mother or father. A godparent is an excellent choice.
This form must be completed in full and returned to St. Agnes Parish Adult Confirmation Coordinator, with a recent copy of the Baptismal certificate.
Should be Empty:

ADULT CONFIRMATION REGISTRATION

BAPTISM INFORMATION

FIRST EUCHARIST INFORMATION

PARENT & SPONSOR INFORMATION