Holy Baptism

Holy Baptism
Name of the Baptismal Candidate*

First & Middle NameLast Name
Preferred date of baptism (note: whenever possible we like to perform Baptisms on the first Sunday of the month-- our Family Service Sunday--but we are happy work with your schedule as well)

MonthDayYear
Date
Date of baptism (to be completed by staff after meeting with clergy)

MonthDayYear
Date
Gender*
Date of Birth*

MonthDayYear
Date
Place of Birth
Have you had pre-Baptismal Counseling?*

YesNo, please scheduleIt is scheduledOther
Parent / Gardian 1*

First NameLast Name
Parent / Gardian 1 Email
example@example.com
Parent / Gardian 1 Phone*
Please enter a valid phone number.
Parent / Gardian 1 Church affiliation*

Member of St. Ann'sWould like to become a member of St. Ann'sOther
Parent/Gardian 2

First NameLast Name
Parent/Gardian 2 Email
example@example.com
Parent/Gardian 2 Phone
Please enter a valid phone number.
Parent/Gardian 2 Church affiliation

Member of St. Ann'sWould like to become a member of St. Ann'sOther
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Relevant Family information
Godparent 1

First NameLast Name
Godparent 1 Phone number
Please enter a valid phone number.
Godparent 1 Email
example@example.com
Godparent 2

First NameLast Name
Godparent 2 Phone Number
Please enter a valid phone number.
Godparent 2 Email
example@example.com
Godparent 3

First NameLast Name
Godparent 3 Phone Number
Please enter a valid phone number.
Godparent 3 Email
example@example.com
Other relevant Godparent information
Clergy Notes
Should be Empty: