Confirmation Certificate Form Name of Confirmed * If applicable, please list Maiden Name as last name First Name Last Name Date of Birth * MM DD YYYY Email * Contact Phone Number * (if we need more information) (###) ### #### What year did you receive the Sacrament of Confirmation? * Are you a parishioner at St. Mary's? * Yes No If not, please indicate the parish where you are currently a member: When would you like the certificate delivered by? * MM DD YYYY Where would you like the certificate to be mailed? * Name of person requesting certificate * First Name Last Name Thank you! Your form has been submitted.
