Are you interested in being confirmed?

Name

First Last

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Date of Birth*

Email

Baptismal Information

Please submit a copy of Baptismal Certificate if not baptized at Prince of Peace or St. Leo's Church.

Place of Baptism

Street Address City State / Province / Region ZIP / Postal Code

Please submit a copy of First Eucharist Certificate if not received at Prince of Peace or St. Leo's Church.

Place of Eucharist

Street Address City State / Province / Region ZIP / Postal Code

Presently Married?*

Annulment?*

Marriages?*

Divorced?*

Current spouse divorced?*