Baptism Certificate Request Form

Requested for:*

MyselfMy child
Child's Information
Full Legal Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Year of Baptism *
Parent's Information
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Personal Information
Full Legal Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Year of Baptism *
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Request Options
How would you like to receive your certificate?*

Pick upMailed to the Parish
Hours for Pickup:

Tuesday - Saturday: 10AM - 6PM
Mailed to Parish

If you are no longer in the area and cannot pick up a copy of your certificate from our parish office, please indicate below the parish address you would like to send, and we will arrange to deliver the certificate.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Hours for Pickup: