Candidate’s Name: _________________________________________

Candidates

Address: ______________________________________________________________

Street: __________________________________________ City: _________________________ Zip Code: __________

Phone Number: ____________________ E-Mail: _________________________

School Attending: _______________________________________ Grade: ________

Candidate’s Birth Date: ______________ City/State of Birth: ________________

Candidate’s Date of Baptism: __________________________

Church, City, State of Baptism: ____________________________________________

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If the person to receive the Sacrament was not baptized at St. Francis Xavier Parish, please contact the church of baptism and have them send a copy of a baptismal certificate to: St. Francis Xavier Parish, 25 W. Perry St., Willard, OH 44890

Father’s Name: __________________________________

Religious Tradition: _________________________________

If different than candidate

Address: ______________________________________________________________

Street: __________________________________________ City: _________________________ Zip Code: __________

Phone Number: ____________________ E-Mail: _________________________

Text Number: ______________________

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Mother’s Name with Maiden Name: _________________________________________

Religious Tradition: _________________________________

If different

Address: ______________________________________________________________

Street: __________________________________________ City: _________________________ Zip Code: __________

Phone Number: ____________________ E-Mail: _________________________

Text Number: ______________________

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Confirmation Sponsor: _____________________________

Relationship to Candidate: ________________________________________________

Sponsor Address: ______________________________________________________

Street City/State Zip Code

Email: __________________________________________________________