Confirmation Sacramentary Information Form

DATE

October 27, 2020

The following information is needed for the Confirmation Candidate receiving the Sacrament.
Candidate Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
City and State of Birth*
Gender*
- Male
- Female
Name at Baptism*
First Middle Last
Date of Baptism*
MM slash DD slash YYYY
Name of Church, City & State of Baptism*
Mother's Name*
First Middle Last
Mother's Maiden Name*
First Middle Last
Father's Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Which Cluster Parish is your family registered with?*
- Holy Trinity, Haugen
- Our Lady of Lourdes, Dobie
- St John the Evangelist, Birchwood
- St Joseph, Rice Lake
- We are not registered in this Cluster
Signature of person submitting information*
Print Name of Signature*
First Last
Date*
MM slash DD slash YYYY