For Teens Entering 8th Grade & Up Next School Year

 

CONFIRMATION 2011-12 ENROLLMENT

Program begins Sept 2011; Sacrament will be received fall of 2012

 

_______________________________________________________________________________

Child’s Last Name                                                                 First                                                           Middle

 

Nickname / Name Child Goes By ____________________________________________

 

Address  ________________________________________________________________

 

City/State/ZIP ____________________________________  Phone _________________

 

Grade 2011-12 School Year ______     School __________________________________

 

Text Box: CIRCLE APPROPRIATE RESPONSE FOR TEEN Mass Attendance: Weekly Monthly Christmas and Easter Only Previous Religious Education Classes, Grades Attended: K 1 2 3 4 5 6 7

 

Text Box: Child Date of Birth _________________ City/State of Birth _____________________ Church of Baptism _______________________________________________________ Date of Baptism __________ City/State of Baptism ____________________________ IMPORTANT NOTE - a copy of your child’s baptismal record is required if he/she was baptized at any church other than St. Teresa Benedicta. Please call the church of baptism and ask that they mail a baptismal record to our parish office before the end of July. Mailing address: 23455 Gavin Lane, Lawrenceburg, IN 47025, Attn. Kim Sprague. Do not hold up completing this form and turning it into the office before the baptismal record is secured. Other Sacraments Received: _____First Holy Communion _____Reconciliation

 

Father’s Formal Name  ____________________________________________________

 

Mother’s Name & Maiden Name  _____________________________________________

 

Text Box: Parent Status: ____Married ____Single ____Divorced ____Separated ____Widowed Child Resides With: ____Mother ____Father ____Both ____Other Is family register in parish ____Yes ____No

 

Parent Emails (most communication sent via email so please offer ones that are accessed frequently):

 

_______________________________________________________________________________________

 

 

Parent Emergency Phone For Use During Day And/Or Class Time:

 

Name __________________________  Cell # ___________________________________

 

Text Box: PARISH OFFICE USE ONLY Confirmation Took Place: Date__________ Presider _____________________________________________________ Entered in Parish Register: By_________ Date _________ Entered in Pds: By_________ Date _________ Letter Mailed to Baptismal Parish: By_____________ Date ____________