CONFIRMATION FOR ADULTS REGISTRATION
ALL INFORMATION MUST BE COMPLETED AND RECEIVED BY FRIDAY, MAY 4, 2012. THANK YOU.
Parish Name*
Address*
City*
Zip*
County
Phone*
Adult Confirmation Parish Coordinator Phone
Adult Confirmation Parish Coordinator Email
CANDIDATE’S PERSONAL INFORMATION
First Name*

Middle
Last*
Street*
City*
State
Zip*
Date of Birth:*
Country of Birth:*
Language Spoken:
Access Information
 
  Wheel Chair Access
 
  ASL Interpreter
 
  Sighted Guide
 
  Assisted Listening Device
Other:
(Please Specify)
CANDIDATE’S SACRAMENTAL RECORD
Church of Baptism:
Date of Baptism:
Church of Baptism Complete Address:
Street:
City/State/zip code (or Country):
Will the Candidate make his/her First Holy Communion?
Candidate’s Full Name
(as it appears on the Baptismal Certificate):
Confirmation Name:
Sponsor’s Name and Parish:
*Please remember to scan all baptismal certificates and letters of eligibility and email them to worship@adphila.org

Adult Confirmation will be celebrated at the Cathedral Basilica of Ss. Peter and Paul on Sunday, May 27, 2012 at 6:30 p.m.