2007-2008 Confirmation Registration

If you have questions, please call Pat Wrucke at 651-463-4100 Ext. 201.

Student Information
	First Name:
	Last Name:
	Middle Name:
	Male Female

	Street Address:
	City:
	Zip:
	Home Phone:
	Child's Email for Youth Events:
	Birthdate:
	Grade as of 9/07
	School Attending:

Has student been baptized? Yes No

Was student registered last year for Confirmation at FLC? Yes No

If no, what is student's Confirmation experience?

Please note any special health concerns or disabilities your child's confirmation guide should know about.

Child lives with: Both Parents Mother Father Other - please specify

Father’s Information
	First Name :
	Last Name:
	Address: (if different from above)
	Home Phone: (if different from above)
	Cell Phone:
	Work Phone:
	Email:

Mother's Information
	First Name :
	Last Name:
	Address: (if different from above)
	Home Phone: (if different from above)
	Cell Phone:
	Work Phone:
	Email:


Tuition: The cost of Confirmation for the year is $35.00 per child with a maximum of $70 per family. Check here if you need a scholarship If you would like to contribute toward a scholarship, please make an additional payment. Farmington Lutheran has a website and occasionally we take pictures of the children participating in church-sponsored events. We'd like to put these on the web page. We will not use names. What is your permission preference regarding pictures posted on the website? Yes No

Student Information