APPLICATION FORM FOR CONFIRMATION

THE CHURCH OF THE INTERCESSION
New York City

APPLICATION FORM FOR CONFIRMATION

INSTRUCTIONS FOR COMPLETING THIS FORM:

Prospective confirmands MUST attend a minimum of THREE 2-hour classes at the church, NOT including the initial introduction.

The Application Form for Confirmation is in three sections:

Applicant Information (date of birth, date of baptism, religious affiliation, etc.)
Applicant Contact Information (phone numbers, home address, etc.)
Parents' Information. (PLEASE NOTE: This section is to be completed only for applicants less the age of 21.)

The very last section is to be left blank, and will be completed by the staff at Church of the Intercession.

If you have any questions about this form, please call the church office at (212) 283-6200.

DATE OF APPLICATION

MM

DD

YYYY

APPLICANT INFORMATION

FULL NAME OF APPLICANT (Please enter First Name and Middle Name, if any, in the FIRST NAME field)

First Name

Last Name

DATE OF BIRTH OF APPLICANT

MM

DD

YYYY

PLACE OF BIRTH (City/State/Country)

IN WHICH DENOMINATION WERE YOU BAPTIZED?

WHERE WERE YOU BAPTIZED? (Name of Church/City/State/Country)

CONTACT INFORMATION

HOME PHONE NUMBER

(###)

###

####

CELL PHONE NUMBER

(###)

###

####

WORK PHONE NUMBER

(###)

###

####

EMAIL ADDRESS

HOME ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PARENT'S INFORMATION (Please fill out this section if the applicant is LESS THAN 21 YEARS OLD)

NAME OF PARENT 1

First Name

Last Name

PARENT 1 - RELIGIOUS AFFILIATION

NAME OF PARENT 2

First Name

Last Name

PARENT 2 - RELIGIOUS AFFILIATION

THIS SECTION TO BE COMPLETED BY CHURCH OF THE INTERCESSION

DATE OF CONFIRMATION

MM

DD

YYYY

TIME OF CONFIRMATION

Hour

Minute

Second

PLACE OF CONFIRMATION (Church Name/Church Address)

PRESENTED BY:

First Name

Last Name

CONFIRMING BISHOP

First Name

Last Name

THE CHURCH OF THE INTERCESSIONNew York City

APPLICATION FORM FOR CONFIRMATION

THE CHURCH OF THE INTERCESSION
New York City