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Confirmation 2019-20 Registration Form
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* Indicates required question
Student Information
First Name
Your answer
Last Name
Your answer
Gender
Female
Male
Clear selection
Birth Date
MM
/
DD
/
YYYY
Will you turn 18 years old during the school year?
Yes
No
Clear selection
Address
Your answer
City/Zip Code
Your answer
Grade Level (Fall 2019)
*
Choose
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Cell # or Home #
Your answer
Email Address
Your answer
School
Your answer
Baptized in the Church of:
Your answer
City/State
Your answer
Are you a St. Vincent de Paul Parishioner?
Yes
No
Clear selection
Primary Parent/Guardian Information
Mother's Name (First and Last)
Your answer
Father's Name (First and Last)
Your answer
Address (if different from student)
Your answer
City/Zip (if different from student)
Your answer
Home # or Cell #
Your answer
Email Address
Your answer
Are you interested in volunteering as a home group facilitator?
Yes
No
Clear selection
Have you had Virtus training?
Yes
No
Clear selection
Student Information
First Name
Your answer
Last Name
Your answer
Gender
Female
Male
Clear selection
Birth Date
MM
/
DD
/
YYYY
Will you turn 18 years old during the school year?
Yes
No
Clear selection
Address
Your answer
City/Zip Code
Your answer
Grade Level (Fall 2019)
*
Choose
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Cell # or Home #
Your answer
Email Address
Your answer
School
Your answer
Baptized in the Church of:
Your answer
City/State
Your answer
Are you a St. Vincent de Paul Parishioner?
Yes
No
Clear selection
Primary Parent/Guardian Information
Mother's Name (First and Last)
Your answer
Father's Name (First and Last)
Your answer
Address (if different from student)
Your answer
City/Zip (if different from student)
Your answer
Home # or Cell #
Your answer
Email Address
Your answer
Are you interested in volunteering as a home group facilitator?
Yes
No
Clear selection
Have you had Virtus training?
Yes
No
Clear selection
Submit
Clear form
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