Our Lady of the Assumption

RELIGIOUS EDUCATION CENTER

1 Molloy Street, Copiague, N.Y. 11726

631-842-3545

 

 

CONFIRMATION SERVICE SHEET

 

 

 

 

STUDENT’S NAME:   ______________________________________________________________________

 

CLASS:    _____________________    TEACHER:    ______________________________________________

 

 

CONFIRMATION SERVICE ACTIVITY

 

Name of Organization or Person Served:  ________________________________________________________

 

__________________________________________________________________________________________

 

Address:  _________________________________________________________________________________

 

__________________________________________________________________________________________

 

Description of Service:   _____________________________________________________________________

                         

__________________________________________________________________________________________

 

__________________________________________________________________________________________

 

Date of Service:   ______________________________  Time Spent:  _________________________________

 

           

                                   

AUTHORIZATION

 

I certify that the student whose name appears above performed the service as described for the amount of time stated.

 

NAME (Print):     _________________________________________  Phone:  __________________________

 

SIGNATURE:  ___________________________________________