Confirmation/Reception/Reaffirmation Form

Please submit this form if you are interested in Confirmation, Reception, or Reaffirmation at Nativity.

Your Full Name (First, Middle, Last) *

Address *

Apt, suite, etc.

Country

City

State

Zip code

Email *

Telephone Number *

Your Date of Birth *

Your Place of Birth (City, State) *

Your Date of Baptism (approximate date is fine) *

Your Place of Baptism *

Have you ever been confirmed in any Christian denomination? *

Yes

If so, in what denomination were you confirmed? *