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Adult Confirmation Form

- Sacraments

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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address: REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Confirmation Name (if applicable): Please enter valid data.
- Birthdate: REQUIRED Please fill out this field. Please enter valid data.
- Birth Place: Please enter valid data.
- Father's Full Name: REQUIRED Please fill out this field. Please enter valid data.
- Mother's Full (Maiden) Name: REQUIRED Please fill out this field. Please enter valid data.
- Parish of Baptism: Please enter valid data.
- Address: Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Have you celebrated First Holy Communion? REQUIRED Yes No Please fill out this field.
- Sponsor's Full Name (if applicable): Please enter valid data.
- Which Mass do you attend?
- What prompted you to receive your Confirmation? REQUIRED Please fill out this field.
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Saints Mary and Joseph Parish

Salem, NH

Adult Confirmation Form