Confirmation Registration

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Confirmation Registration Form

Please fill out this form to formally register for Confirmation. Please note that you will need the date of your Baptism to complete the form. You will also need the address of the Church of Baptism, if you weren’t Baptized at St. Dominic.

If you have questions or concerns about this form, the preparation process or the Sacrament of Confirmation itself, please contact Russ Petrus, Pastoral Associate, by email at russpetrus@gmail.com or by phone at 216-991-1444.

1 Information About the Person to be Confirmed

2 Information About Parents

3 Sacramental History

First Name (of person to be Confirmed)*
Middle Name (of person to be Confirmed)*
Last Name (of person to be Confirmed)*
Date of Birth*

MM

DD

YYYY
Gender
- Male
- Female
Address*

Street Address
Address Line 2
City

State
Zip Code
Phone number*
Enter a valid email address that gets read often*

Enter Email
Confirm Email

Mother's First Name*
Mother's MAIDEN Name*

We need your mother’s maiden name for accurate recording on the Baptismal Record.
Father's First Name*
Father's Last Name*

Were you Baptized at St. Dominic Church?*
- Yes
- No
What is the name of the church you were baptized at?*
Address of Church of Baptism*

Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code

Country
Date of Baptism*

MM

DD

YYYY
Did the person to be confirmed receive First Communion at St. Dominic?*
- Yes
- No

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Confirmation Registration

Confirmation Registration Form