Prince of Peace Lutheran Church

2021-22 PoP Confirmation Class Registration

Please complete sections to the best of your ability. Items marked with an * are required. Please register by 9/12/21. Parent Orientation is via Zoom on 9/22. Student Orientation is via Zoom on 9/29. Classes begin in-person (as of now) on 10/6.page 1 of 1

YOUTH SECTION: Please use a separate form for each child you are registering.


First Name Last Name


Phone Number
Address
Address Line 2
City State Zip Code


Select one
Yes
No

Select one
6th
7th
8th
9th
Do not know / have not attended here before
Select one
Yes
No
They would be interested in receiving membership information
Select one
Online/virtual
In-Person
It depends


First Name Last Name

First Name Last Name
Phone Number
Email Address
Select one
Yes
No
I/We are interested in receiving membership information

Select one
Yes
No
Select one
Yes
No
Select one
Yes
No
Select one
Yes
No
Maybe- Would like more information
Select one
weekly
bi-weekly
Substitute
Select one
Yes
No
Maybe
Select one
Yes
No
Maybe

Select one
Yes
No


* required