Confirmation Request Form

Please complete the following form. At the bottom, you will notice an anti-spam authentication box. Please complete it as instructed. To submit the form, please click on "Send". Should you have more names than spaces allotted, please submit an additional form.

Parish: Please select your parish. Angola - Holy Family Berne - St. George's Bristol - St. John of the Cross Chesterton - St. Francis' Crown Point - St. Christopher's Culver - St. Elizabeth's East Chicago - Good Shepherd Elkhart - St. David's Elkhart - St. John the Evangelist Fort Wayne - Grace Fort Wayne - St. Alban's Fort Wayne - Trinity Gary - St. Augustine's Gary - St. Barnabas-in-the-Dunes Gas City - St. Paul's Goshen - St. James' Griffith - St. Timothy's Hobart - St. Stephen's Howe - St. Mark's Huntington - Christ the King Kokomo - St. Andrew LaPorte - St. Paul's Logansport - Trinity Marion - Gethsemane Michigan City - St. Andrew's-by-the-Lake Michigan City - Trinity Mishawaka - St. Paul's Munster - St. Paul's Plymouth - St. Thomas' Rensselaer - St. Peter's South Bend - Cathedral of St. James South Bend - Holy Trinity South Bend - St. Michael & All Angels Syracuse - All Saints Valparaiso - St. Andrew's Warsaw - St. Anne's


What type of confirmation certificate do you require? None Blank Only Signed Completed


How many certificates do you require?


Persons to be confirmed.

Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:


Persons to be received.

Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:


Persons making a reaffirmation of faith.

Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:
Name:      Age:      Baptized in:



Any special instructions?

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