Our Lady of the Valley R.C. Church
CONFIRMATION INFORMATION FORM
First Name
Last Name
Baptismal Name
Confirmation Name
Date of Birth
mm/dd/yyyy
High School
Home Phone Number
area code & number no dashes: 1112223333
Current Grade
Freshman
Sophomore
Junior
Senior
Mass usually attended
Choose as many that apply
Saturday 5pm
Sunday 8am
Sunday 10am
Sunday 12noon
other
do not attend mass
Antioch Program
Choose only one
Fall Antioch Weekend
Spring Antioch Weekend
March 1 day workshop
Service Hours Completed
(
Enter values between 1.0 and 30.0
)
Preakness Visits Completed
Please select one.
none
1
2
3
4
5
Experience
Essay: Insert or type your essay on why you want to be confirmed.
Additional Comments
(optional)
Our Lady of the Valley
630 Valley Rd
Wayne, NJ 07470
(973) 696-8307
Site Designed and maintained by
Lindsey Wolak
Last Updated: Tuesday, December 18, 2007
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