ST FRANCIS XAVIER SCHOOL
INFORMATION SHEET FOR FIRST EUCHARIST AND FIRST RECONCILIATION
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It is very important to complete and return this form as soon as possible so that our records can be completed.
Child’s Information:
Child’s Last Name _______________________ First Name ___________________ Middle Name ______________
Address: ____________________________________________________________________________
City: _________________________________________________________________________________
Preferred phone: __________________________________________________________________
Preferred email: ___________________________________________________________________
(Be sure to fill this out. I use email for updates & changes.)
Date of birth: ________________________Place of birth:_____________________________
Church of Baptism: _______________________________________________________________
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City, State: _________________________________________________________________
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Approximate Date of Baptism: ________________________
(All records are kept at church of Baptism so after your child receives the Sacrament I have to inform the church of Baptism. We need proof of Baptism.)
Parents’ Information: (Fill out if different.)
Father’s Name: ___________________________________________________________________
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Address: ______________________________________________________________________
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______________________________________________________________________
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Phone: ________________________________cell: _________________________________
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Religious Tradition: _________________________________________________________
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email ___________________________________________________
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Mother’s Name: _______________________________________ Maiden Name: ________________
Address: ____________________________________________________
_____________________________________________________
Phone: _______________________________cell:______________________________
Religious Tradition: _________________________________________________________
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email ___________________________________________________
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PLEASE:
1. Return this form ASAP to Monica Sieja
2. If the person to receive the Sacraments 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, c/o Monica Sieja, 25 W. Perry St., Willard, OH 44890