Confirmation Sacramentary Information Form

2021-22 Confirmation Sacramentary Information

"*" indicates required fields

Will you be using a debit/credit card to pay for your student's Confirmation Sacramentary fee?

Yes

Not Paying by Credit Card

Please contact Leah Kurzynski at the Faith Formation Office to schedule an appointment to sign up for Confirmation in person.

lkurzynski@stjosephricelake.org
715-736-3104

Candidate Information

The following information is needed for the Confirmation Candidate receiving the Sacrament.

First name*

Middle Name*

Last Name*

Date of Birth*

City and State of Birth*

Gender*

Male

Female

Name at Baptism*

First

Baptism Middle Name*

Middle

Baptism Last Name*

Last

Date of Baptism*

Name of Church, City & State of Baptism*

Mother's Name*

First

Mother Middle*

Middle

Mother Last*

Last

Mother Maiden Name*

Father's Name*

First

Father's Middle*

Middle

Father's Last*

Middle

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*

Checkout / Payment

Would you like to cover the Credit Card Fees?*

Credit Card Processing Fee

Price: $0.00

Confirmation Sacramentary fee*

Price:

Subtotal

$0.00

Credit Card

Card Details

Cardholder Name

Name

This field is for validation purposes and should be left unchanged.