Sacramental Certificate Request Form
Please complete this form to the fullest extent. To comply with the Data Protection Act and in order to protect the confidentiality of these records. Certificates will only be issued to the individual named on the certificates, the parent or guardian of a minor child, or a requesting parish or Diocese.
Full Name of Request
*
Father's Full Name
Mother's Full Maiden Name
Present Address
*
Street Address
Street Address Line 2
City
State / Province
Postcode
Address at time of Sacrament if Known
Street Address
Street Address Line 2
City
State / Province
Postcode
Baptism God Parent if Known
Baptism God Parent if Known
Telephone Number
*
Please enter a valid phone number.
Email address
*
Confirmation Email
example@example.com
Date of Birth
*
-
Day
-
Month
Year
Date
Date of Sacrament if Known
-
Day
-
Month
Year
Date
Certificate Required (Please Select which certificate/s you require)
*
Baptismal Certificate
Confirmation Certificate
Marriage Certificate
Name of Person Requesting a Sacramental Certificate
*
I request the certificate as indicated above and confirm that in the case of a Baptism or Confirmation Certificate, I am the individual or where the individual is a minor I am the parent or guardian of that individual. In the case of a Marriage Certificate, I am one of the individuals.
I confirm that all the information I have given above is true to the best of my knowledge and belief.
Date Of Request
*
-
Day
-
Month
Year
Date
GDPR NOTICE
*
The parish of St John the Evangelist operates in accordance's within the Diocese of Down and Connor privacy notice, a copy can be found on the parish website https://stjohnsfallsroad.org/wp-content/uploads/2020/09/Privacy-Notice-DC-31-May-18.pdf.
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Sacramental Certificate
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