Confirmation Student Information Please complete in ink

Confirmation Student

Nick Name

Grade

School

Birth Date:______/______/______

Which worship service do you usually attend?

Address

City:

State:

Zip Code:

Phone Number

Listed_______  Unlisted________

Email Address

How often do you check your Email?

What hobbies and interest's do you have?

Do you participate in any extra curricular activities?: (sports, club's, organizations) Please list:

Do you play any musical instruments? Please list:

Do you have experience or interest in drama?

Do you have experience or interest in singing?

Parent Section

Parents' Names:

Home phone Number:

Work phone Number:

For ?

Work phone Number:

For ?

(Phone Numbers are not for publication. For office use only.)

Email Address

How often do you check your Email?

Is Email address At home or work? Elsewhere?

Is there anything about your child that you would like to share so that we may better work with your child?

(Use back of form to explain)

How are you available to assist St. John Confirmation Ministry?

(i.e. planning, driving, making phone calls, small group guide, assist with Parent Talk events, etc.)

EMERGENCY CONTACT INFORMATION for Wednesday Nights

Pager #

Cell Phone

For

Addition contact person                                                                       phone #

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