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Confirmation Registration Form
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- Candidate Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Age REQUIRED Please fill out this field. Please enter an integer (number).
  
  Street Address 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Current Parish REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Parish of Baptism Please enter valid data.
  
  Parish of Baptism Street Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  First Communion Date REQUIRED Please fill out this field. Please enter a date.
  
  First Communion Location Please enter valid data.
  
  First Reconciliation Date REQUIRED Please fill out this field. Please enter a date.
  
  First Reconciliation Location Please enter valid data.
  
  Please confirm your desire to become a candidate.
  I hereby signify that I desire to become a candidate for the Sacrament of Confirmation and wish to participate in the Resurrection Church Confirmation Program. Please select this field.
- Parent Information
  
  Father's First and Last Name Please enter valid data.
  
  Mother's First and Maiden Name Please enter valid data.
- Sponsor Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Sponsor Street Address 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.
  
  Sponsor Parish 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.
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- Faith

Resurrection Catholic Church

Grand Island, NE

Confirmation Registration Form