Adult Inquirer's Class Registration | The Chapel of the Cross of Chapel Hill, NC

Adult Confirmation/Reception Application

Confirmation, Reception or Reaffirmation of Baptismal Vows? *

Confirmation

Reception

Reaffirmation of Baptismal Vows

Not Sure

Name *

First

Middle

Last *

Last

Name to be used by the Bishop

First

Last Name to be Used

Last

Date of Birth *

Place of Birth *

City

Place of Birth – State *

State / Province / Region

Address *

Street Address

Address Line 2

City *

State / Province / Region *

ZIP / Postal Code *

Home Phone

Mobile Phone

Email *

Baptism Information

Place of Baptism

Church, City, State

Do you know the date of your baptism? *

Yes

Date of Baptism

Date of Baptism – Day

Date of Baptism – Year *

YYYY

Time period of your life you were baptized

Infancy, childhood, etc.

Have you been confirmed? *

Yes

Date of Confirmation *

Date of Confirmation – Day *

Date of Confirmation – Year *

YYYY