Application for Reception of Sacraments 2025

2025 First Reconciliation and First Eucharist

Copy (scan or photo) of Baptism Certificate (if not baptized at NBVM)
MUST be submitted either using the File Upload option at bottom of Application, emailed to prep@nativity-bvm.org or mailed to Rectory at 30 E Franklin St. Media, PA 19063.

Due 3/31/2025

Name of Child Name of Child * First Last
Full Name (no nicknames)
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Date of Birth Date of Birth * / MM / DD YYYY
Place of Birth (City, State) *
Church of Baptism (name) *
Baptism Church (City, State) *
Date of Baptism Date of Baptism / MM / DD YYYY
Father's Name Father's Name * First Last
Mother's Name (Maiden) Mother's Name (Maiden) * First Last
Payment Options for the $75 Sacramental Preparation Fee: *

Payment Options for the $75 Sacramental Preparation Fee: Pay online through Parish Giving (you will be redirected to Parish Giving page after you click submit) Drop a check/cash at Rectory Office
Signature Signature * First Last
Email *
Copy of Baptism Certificate

Attach Files

Upload a photo or scan of Baptism Certificate