CONFIRMATION PREP PROGRAM Year 2 - 11th Grade

Full Name *

Date of Birth *

Age at Confirmation *

School Attending *

Candidate's Confirmation Saint Name *

Mother's Full Name *

Father's Full Name *

Mailing Address *

Parent Email *

Home Phone *

Cell phone number preferred. If you do not have a cell phone, land line is acceptable.

Work Phone *

Mother's Cell Phone *

Father's Cell Phone *

Student's Email *

Student's Cell Phone *

Sponsor's Full Name *

Sponsor's Mailing Address *

Sponsor's Cell/Home Phone *

NO FEES. Please make a donation directly to St. John the Evangelist Church, Plaquemine, LA.

Phone

57805 Main Street
Plaquemine, Louisiana 70764

Phone: 225-687-2402
Fax: 225-687-1587
Prayer Line: 225-687-1554

E-mail: stjohnchurchplaq@coxbusiness.net