St. Kilian Parish

485 Conklin Street Farmingdale, NY 11735
516-249-0127

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Request a Confirmation Certificate

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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.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Date of Confirmation (if known) REQUIRED Please fill out this field. Please enter valid data.
- Mother's name (maiden) REQUIRED Please fill out this field. Please enter valid data.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address 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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- How would you like to receive your certificate? REQUIRED Mail it to me I will pick it up at the rectory Please fill out this field.
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