Divine Mercy Parish
Registration for Adult Confirmation 2013
John testified further, saying, “I saw the Spirit come down like a dove from the
sky and remain upon him…Now I have seen and testified that he is the Son of God.”
- John 1:32 and 34
PLEASE PRINT:
About You:
Last Name: _________________________ First Name: ____________________________ Middle Name: _____________________
Maiden Name: ______________________________ Date of Birth: ____________________________
Address: _________________________________________________________________________________________________
City: __________________________ Zip: __________________
Phone (Home): ______________________________________
Phone (cell): ________________________________________
E-Mail: ___________________________________________________________________
We ask that you please provide us with a copy of your baptismal certificate, if you have it.
If not, you can assist us in locating your baptismal record by providing us with…
Parish of your Baptism: ___________________________________________________________
City/State: ______________________________________________________________________
Approximate date of baptism : ______________________________________________________
Mother’s Full Name (including her maiden name): ____________________________________________________________
Father’s Full Name: ___________________________________________________________________________
Have you received 1st Holy Eucharist (in the Catholic faith)? [ ] Yes
[ ] No
Have you received 1st Reconciliation (in the Catholic faith)? [ ] Yes
[ ] No
Are you currently a member of Divine Mercy Parish?
[ ] No
[ ] Yes
If no, to which parish do you belong? _______________________________________________________________________
Your Sponsor Information (your sponsor must also fill out the enclosed form)
Sponsor’s Name: ____________________________________________________________________________________
Sponsor’s Address: __________________________________________________________________________________
City: ________________________________ State: _______________ Zip: ___________________________
Phone: _______________________________________
E-Mail: _____________________________________________________
Sponsor’s Parish: _____________________________________________________