Our Lady of Lourdes Request Confirmation Certificate

Request Confirmation Certificate

If the individual was Confirmed at Our Lady of Lourdes in Gales Ferry, CT, you may request a Confirmation Certificate by:

Name of Confirmation: First, Middle, Last Name

Date of Birth: mm/dd/yyyy

Year or Date of Confirmation:

Why do you need the certificate?: (please specify reason)

Name of Father: First, Middle, Last Name

Name of Mother: First, Middle, Last Name

Mailing Address:

City: State: Zip:

Phone Number:

Your Name:

Relationship to Confirmed:

Your Email Address:

Mail to the address above I will pick it up at the rectory