Logo for St. Augustine's Episcopal Church, Croton-on-Hudson, featuring stylized text and design in red and orange hues, emphasizing the church's name.

Confirmation Request Form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Student's Full Name (First, Middle, Last)*
Preferred pronouns

MM slash DD slash YYYY
Student's City, State of Birth*
MM slash DD slash YYYY
Student Mailing Address*
Student School and Grade Level in Fall*
Parent/Guardian Contact 1 Name*
Parent/Guardian Contact 2 Name*
I am interested in learning more about Christianity and the Episcopal Church this Fall while my child(ren) prepares for Confirmation.*