BAPTISM APPLICATION FORM
Presentation of the Blessed Virgin Mary Roman Catholic Church
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
City of Birth:
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
In case you need to be contacted
E-Mail:
*
example@example.com
PARENTS
Father's Name
*
First Name
Middle Name
Last Name
Religion/Denomination:
*
Mother's Maiden Name
*
First Name
Middle Name
Maiden Last Name
Religion/Denomination:
*
Marital Status:
*
Married in the Church?
*
Yes
No
GODPARENTS
Godfather's Name
First Name
Middle Name
Last Name
Church/Parish Affiliation:
*
Godmother's Name
First Name
Middle Name
Last Name
Church/Parish Affiliation:
Have you (the parents) attended a Baptismal Class?
*
Yes
No
Location of Class?
Who presented the class?
Please upload a copy of your child's birth certificate or hospital birth record:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Baptismal Certificate:
Receive by mail
Pick-up in parish office
Registered Parishioners?:
*
Yes
No
What is your reason for having your child baptized at PBVM?:
*
i.e. Availability, Grandparent's are parishioners, etc.
Preview PDF
Save
Submit
Should be Empty: