Author: Marc Gagne

Spring—2021 Saint Anne Parish Confirmation Registration Form Please read and initial the information in the column to the right.

Parent/Guardian Information Family Name:_______________________ Father’s Full Name:_________________________________________________________________________
Cell Phone: ______________________________ Work Phone: _______________________________
Mother’s Full Name: ________________________________________Maiden Name:___________________
Cell Phone: ______________________________ Work Phone: _______________________________
Mailing Address:____________________________________________________________________________ Street Town & State Zip
Email Address:____________________________________________ Home Phone: ______________________
Emergency Contact Person other than Parent:______________________________________ Phone:__________________________

FIRST CHILD
Name:___________________________________________________ Date of Birth:______________________
Medical Condition(s):_______________________________________ Place of Birth:_____________________
School of Attendance:____________________________ Grade for 2020-2021 ________ [ ] Male [ ] Female
CONFIRMATION: 6 sessions
[ ] Thursday - 2/4, 2/11, 2/18, 3/4, 3/11, 3/18 ~ 3:00—4:00 pm in church or online
And Confirmation Retreat - online
Sacraments already received:
[ ] Baptism (Church_____________________)[ ] 1st Reconciliation (Church _____________________)
[ ] 1st Eucharist (Church___________________________)
[ ] 1st Eucharist (Church___________________________)

SECOND CHILD
Name:___________________________________________________ Date of Birth:______________________
Medical Condition(s):_______________________________________ Place of Birth:_____________________
School of Attendance:____________________________ Grade for 2020-2021: ________ [ ] Male [ ] Female
CONFIRMATION: 6 sessions
[ ] Thursday - 2/4, 2/11, 2/18, 3/4, 3/11, 3/18 ~ 3:00—4:00 pm in church or online
And Confirmation Retreat- online
Sacraments already received:
[ ] Baptism (Church_____________________)[ ] 1st Reconciliation (Church _____________________)
[ ] 1st Eucharist (Church___________________________)
[ ] 1st Eucharist (Church___________________________)

I understand that:
Registration forms may be returned by mail only when accompanied by full payment.
Registration forms with partial payment or in need of
other arrangements,
including scholarships, must be completed in the office with a faith
formation staff member.
Registration forms received without payment will not be able to be processed.
Any outstanding fee from the previous year should be satisfied at the time
of any new registration.
_________________ Initials of Preparer

2021
Fee Schedule:
Program Fee:
Per Child $100.00
Retreat fee included in cost
Non-Parishioner* Program Fee:
Per Child $150.00
Non-Parishioner fee applies to those who wish to participate in the St. Anne Faith Formation Program but are not a registered family at Saint Anne Parish.
Registering in the Parish for the sake of the Faith Formation Program does not qualify you for the regular program fee until you have been registered parishioners for 1 year.
Families newly relocated, by way of a new physical address, would be considered regular parishioners and the regular program fee would apply.

CANDIDATE COMMITMENT
As a candidate for Confirmation, I agree to the following:
I understand that missing more than one out of the six classes may mean re-doing the program the next year.
I understand that I am required to participate in a retreat.
I will approach my Confirmation journey with an open mind and an open heart.
I will be respectful of the leaders of the program and the other students.
I will attend Mass every Sunday and on all holy days of obligation.
I will receive the Sacrament of Reconciliation before my Confirmation.
I will accept more responsibility in my family, parish, and community by putting my talents and gifts at the service of others.
As I make these promises, I ask God to give me the grace to be open to his plans for my life—plans he reveals to me in prayer, in my talents and aspirations, and in the encouragement of those who know and love me. I place myself in the loving embrace of the Father, Son, and Holy Spirit in asking for help in fulfilling this commitment.
Name of Candidate (Print) Signature of Candidate Date
Witnessed by: Signature of Candidate’s Parent/Legal Guardian

For Office Use:
Date
Recv’d: _________
[ ] By Mail
[ ] In Office
Total Due: _________
Payment
Recv’d: _________
[ ] Check # _________
[ ] Cash
Balance Due: _________
Registration taken by: _________
(Initialed)

VOLUNTEER SUPPORT
Your support assists in providing a quality experience of faith formation for your child. Please indicate grade levels and areas that you would be willing to assist.
I am willing to serve, where appropriate as:
[ ] Catechist/Teacher [ ] Aid/Assistant

My signature indicates that to the best of my knowledge the information I have provided on this registration form is accurate and true.
__________________________________________________________ _____________________ Signature Date

SCHOLARSHIPS Scholarship assistance is available on a limited basis and is considered on a case by case basis. Please talk with Pam Walsh or Joan Virga for specifics and how to apply.
Return completed
registration form along with payment to :
Saint Anne Parish Faith Formation 26 Emerson Avenue PO Box 339 Hampstead, NH 03841