Immaculate Heart of Mary
Catholic School

Burlington, Kentucky

Adult Confirmation Registration

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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Church Where Baptized REQUIRED Please fill out this field. Please enter valid data.
  
  Address of Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism: REQUIRED Please fill out this field. Please enter valid data.
  
  Marriage Information REQUIRED Please fill out this field.
  
  You must obtain and provide a new copy of your Baptismal Certificate not later than April 22.
  
  The IHM Confirmation orientation session will be on Wednesday April 28, 7 PM in Meeting Room 1.
  
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