St. Mary Cathedral Parish Confirmation Registration Form 2016-2017 PLEASE PRINT The information provided below is considered CONFIDENTIAL and is used only for communication purposes by this office.
CANDIDATE INFORMATION: Candidate Name: __________________________________________________________________________________ Last First Middle Address: ________________________________________
Home Phone: (
) _______________________
City/St: ________________________________________ Zip: ___________ Male ! Female ! T-Shirt Size:______ Candidate’s E-mail: _________________________________ Parent’s E-mail: ________________________________ Candidate’s School: ______________________________________ Grade: ______ Date of Birth: ________________
PARENTS/GUARDIANS INFORMATION: Relationship: _________________________________
Relationship: _________________________________
(Father, Stepfather, Grandfather, etc.)
(Mother, Stepmother, Grandmother, etc.)
Name: ______________________________________ First Last
Name: ______________________________________ First Last
Occupation: ___________________________________
Occupation: __________________________________
Cell Phone: (
Cell Phone: (
) _______________________
) _______________________
Religion: Catholic ! Other: ________________
Religion:
Catholic ! Other: ________________
Marital Status: Married in the Catholic Church !
Student lives with: Both Parents ! Guardian !
Civil ! Single ! Widower ! Divorced !
Father ! Mother !
ELIGIBILITY/FAITH FORMATION EXPERIENCES: ! Registered in the Parish
! Baptized Catholic ! Attends Sunday Mass Weekly
! Has received First Reconciliation and First Holy Communion ! Completed 8th Grade Religious Education or 8th Grade at Catholic School Baptism ! Date: ______________________
Reconciliation ! Date: ______________________
Eucharist ! Date: ______________________
Church: ____________________
Church: ____________________
Church: ____________________
City: ______________________
City: ______________________
City: ______________________
State: _____________________
State: _____________________
State: _____________________
REGISTRATION REQUIREMENTS: Along with this completed form: ! Course fee: $75.00 ($55 if have book from Pre-Confirmation Last Year) ! Copy of Baptism Certificate is attached (not required if baptized at St. Mary Cathedral) Checks may be made payable to: St. Mary Cathedral / Memo: Confirmation Program Questions? Contact Christina Gerkey
[email protected] PLEASE COMPLETE BACK SIDE
For Office use: -----------------------Amount Paid:______ Cash or Ck #:______ Date Rcvd: ________