 Confirmation 2007-2008 On-line Registration Form
When you finish filling in all of the blanks, click on the Submit Registration button at the
bottom of the form to transmit your child's registration to the church office. Please submit only one
form per child.
There is a registration fee of $10 for each new confirmation student. Please make checks payable to St. John and give them to the Confirmation Director.
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Child's Information
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| Full Name |
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| Nickname |
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| School |
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| Grade |
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| Date of Birth (MM/DD/YYYY) |
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| Service usually attended |
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| Address |
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| City, State |
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| ZIP |
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| Phone |
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| Is this number unpublished? |
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| Email Address |
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| How often do you check email? |
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| Hobbies and interests |
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| Extracurricular Activities |
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| Musical Instruments |
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Names of other Confirmation students with whom you would like to be paired in small group (same grade). No guarantees!
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Parents' Information
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| Parent's Name |
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| Work Phone |
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| Cell Phone |
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| Home Phone |
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| Email Address |
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| Location of email address (e.g. home, work) |
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| How often do you check email? |
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| Parent's Name |
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| Work Phone |
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| Cell Phone |
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| Home Phone |
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| Email Address |
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| Location of email address (e.g. home, work) |
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| How often do you check email? |
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| What religious background does your child have? |
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| Has your child been baptized? |
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| Does your child currently receive communion? |
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Are you available to help (e.g. planning, driving, making phone calls, small group guide, assist with events, etc)? If so, please list how:
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Additional information about your child so that we may better work with him/her?
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Emergency Contact Information
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| Name |
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| Phone |
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| Cell Phone |
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| Pager |
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| Name |
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| Phone |
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| Cell Phone |
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| Pager |
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