Confirmation Registration

The St. Rita Confirmation Program
is a ONE year program for students in their JUNIOR year.

The cost per child for Confirmation is $40.00.

Call 445-7141 x 217 with any questions
you may have.

Courtney Brinkman

Student's Full Name (First, Middle, Last) REQUIRED Please fill out this field. Please enter valid data.

Choose one: Male Female

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

School Attending REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field. Please enter valid data.

Student's Email Please enter valid data.

Student's Cell Please enter valid data.

Baptism Date and Church of Baptism REQUIRED Please fill out this field. Please enter valid data.

Father's Full Name Please enter valid data.

Father's Cell Please enter valid data.

Father's Email Please enter valid data.

Mother's Full Name (First, Middle/Maiden, Last) Please enter valid data.

Mother's Cell Please enter valid data.

Mother's Email Please enter valid data.

Street Address REQUIRED Please fill out this field. Please enter valid data.

City & State REQUIRED Please fill out this field. Please enter valid data.

Zip Code REQUIRED Please fill out this field. Please enter valid data.

By typing my name below, I agree to the following:

I give my permission to St. Rita Church to send text messages to my cell phone.
I give my permission to St. Rita Church to take pictures of my child(ren) on various occasions throughout the year for social media, Church Today and the St. Rita website.

Parent's Signature Please enter valid data.

Date (MM/DY/YEAR) REQUIRED Please fill out this field. Please enter valid data.

A payment button will be coming soon. If you are registering your child at this time, please call the office with your payment or mail to the office at 4401 Bayou Rapides Rd, ALexandria, LA 71303.