St. Joseph Catholic Church

&

St. Louis Mission Chapel

Confirmation

- Sacraments & Policy
  - Confirmation
  - First Communion

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- Candidate Name REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- DOB REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Phone number REQUIRED Please fill out this field. Please enter valid data.
- e-mail REQUIRED Please fill out this field. Please enter valid data.
- Name of the school attending REQUIRED Please fill out this field. Please enter valid data.
- What grade will they be in this upcoming school year? REQUIRED Please fill out this field. Please enter valid data.
- If applicable, list any medical information we may need to be aware of (allergies)
- List any siblings already in our CCD program
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of First Communion REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Date of First Communion REQUIRED Please fill out this field. Please enter valid data.
- Are you a registered parishioner of St. Joseph Church / St. Louis Chapel? REQUIRED Please fill out this field.
- Father / Guardian's contact information
  
  First and last name REQUIRED Please fill out this field. Please enter valid data.
  
  cell phone REQUIRED Please fill out this field. Please enter valid data.
  
  e-mail Please enter valid data.
- Mother / Guardian's contact information
  
  First and last name REQUIRED Please fill out this field. Please enter valid data.
  
  cell phone REQUIRED Please fill out this field. Please enter valid data.
  
  email address (for contact and reminder purposes only) REQUIRED Please fill out this field. Please enter valid data.
- Mailing address REQUIRED Please fill out this field.
- Emergency contact #1
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone number REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to child REQUIRED Please fill out this field. Please enter valid data.
- Emergency contact #2
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone number REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to child REQUIRED Please fill out this field. Please enter valid data.
- Confirmation Fee (put towards retreat and gown cleaning)30.0
- By checking the box below you agree that your child may receive a Safe Environment lesson at least once this school year. This type of lesson is designed to help educate your child about what a safe environment is and how to recognize situations which may be harmful.
  I Agree Please select this field.
- By checking the box below you hereby grant permission to St. Joseph Catholic Church and St. Louis Mission Chapel (Parish), its representatives and employees, the right to take photographs and videos of my child at any and all activities associated with the Parish, to be used for promotional purposes. I authorize the Parish to copyright, use, and publish the same in print and/or electronically. I further agree that the Parish may use such photographs and videos without restriction for advertising, trade, promotion, or any other lawful purposes.
  I Agree Please select this field.
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