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2020-2021 Confirmation Registration
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Last Name:
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First Name:
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Your answer
Middle Name:
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Your answer
Preferred Name:
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Your answer
Address:
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Date of birth:
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City and state of birth:
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School:
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Grade:
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Church of baptism: (If your student was not baptized at St. Francis Xavier, please obtain a copy of the baptism certificate dated within the last 6 months. You can request a copy from the church where your child was baptized.)
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Date of baptism:
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Does your student have any allergies, medical issues or special concerns? Please explain:
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