Confirmation Registration Form – Holy Rosary Burlington

CONFIRMATION REGISTRATION FORM

Candidate’s Full Name

First Name

Middle Name

Surname

Male/Female

Address

Number and Name

Str. Ave. etc

Apt. / Unit

Phone Number

City

Enter City Name

Postal Code

Place of Birth

Enter City Name

Province/State

Date of Birth

Family Contact Email

Enter email here

School

Enter name here

Grade

Father’s Full Name

First Name

Middle Name

Surname

Religion

Address (If Different)

Number and Name

Str. Ave. etc

Apt. / Unit

Phone number

City

Enter City Name

Postal Code

Mother’s Full Name

First Name

Middle Name

Maiden Name

Religion

Address (If Different)

Number and Name

Str. Ave. etc

Apt. /Unit

Phone number

City

Enter City Name

Postal Code

CANDIDATE’S BAPTISM INFORMATION

Baptism Information

Select a Date

Enter Church Name

Enter City Name

Province/Sate

Please attach a photocopy of your child’s Baptism Certificate if not baptized at Holy Rosary

If you are human, leave this field blank.