Confirmation Registration Form

Candidate Information:

First Name: (required)

Middle Name: (required)

Last Name: (required)

Birth date(*): (required)

Grade: (required)

Age: (required)

Street Address: (required)

City: (required)

State: (required)

Zip Code: (required)

Parent's Email: (required)

Parent's Telephone: (required)

Father's Information:

First Name:

Middle Name:

Last Name:

Mother's Information:

First Name:

Middle Name:

Last Name:

Maiden Name:

General Information:

Which church site does your child attend?

(A copy of the First Eucharistal Certificate must to be provided if baptized outside of Blessed Trinity/St. Patrick Parishes)

Please note the date and location of the following sacraments:

Baptism date(*): (required)

Place of Baptism:

Church Name: (required)

Street Address: (required)

City: (required)

State: (required)

Zip Code: (required)

First Penance date(*): (required)

Place of First Penance:

Church Name: (required)

Street Address: (required)

City: (required)

State: (required)

Zip Code: (required)

First Eucharist date(*): (required)

Place of First Eucharist:

Church Name: (required)

Street Address: (required)

City: (required)

State: (required)

Zip Code: (required)

I give permission for non-tagged (name not included) pictures of my child to be used for informational purposes only. This may include the parish website, newspapers, Parish Facebook, or parish pictures directories. (required)

I understand that instruction for the 2-year preparation program is part of the Parish Youth Group Meetings. Regular attendance and participation in retreats is required. (required)

Additional Comments?

(*) Depending on your browser, the date can be accepted in many ways. Below are a few examples.

Microsoft Internet Explorer: (YYYY-MM-DD)
2016-01-05

Microsoft Edge with Windows 10: (has the ability to click and select a date, but uses MM-DD-YYYY)

Google Chrome: (has the ability to click and select a date, but uses MM-DD-YYYY)

If problems persist, please email the webmaster (email at the bottom of this page) with the browser you are using.