Baptismal Information

Baptismal Information
Child to be Baptized*

First NameMiddle NameLast Name
Email Address of Person Submitting Form*
example@example.com
Sex of Child*

MaleFemale
Child's Date of Birth:*

MonthDayYear
Child's Place of Birth:*
City where Born
State*
State where Born
Has the child been previously baptized?*

YesNo
Is the child adopted?*

YesNo
Parents of the Child (as listed on birth certificate or legal custody documents):
Father's Name*

First NameMiddle NameLast Name
Religion:*
Father's Religion
Church Attendance:*

FrequentlyOccasionallySeldom
Parish Where Registered or Church Attending:*
Enter the Church you Attend
Mother's Name*

First NameMiddle NameLast Name
Mother's Maiden Name*
Religion:*
Church Attendance:*

FrequentlyOccasionallySeldom
Parish Where Registered or Church Attending:*
Parents Address*

Parents Address

Street Address Line 2

CityState

Zip
Phone Number*

Area CodePhone Number
Are the Parent Married?*

YesNo
Married in the presence of a Catholic priest or deacon?*

YesNo
Date of Baptismal instructions:

MonthDayYear
Sponsors of the Child:
Godfather’s name:*
Religion:*
Godmother’s name:*
Religion:*
If either godparent will be represented by proxy, list the proxy below.
Name of Proxy:
Proxy for:
Name of Priest/Deacon Preferred:
Baptismal Date & Time 1st Choice:

MonthDayYear
DateHourMinutesAM/PM Option
Baptismal Date & Time 2nd Choice:

MonthDayYear
DateHourMinutesAM/PM Option
Should be Empty: