Application for Reception of Sacraments

2019-20 First Reconciliation and First Eucharist

Copy of Baptism Certificate (if not baptized at NBVM)
MUST be submitted to Rectory.

Due 3/1/2020

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 $150 Sacramental Preparation Fee: *

Payment Options for the $150 Sacramental Preparation Fee: Pay online through Parish Giving Drop a check/cash at Rectory Office
Signature Signature * First Last
Email *