Sacramental Certificate Request
Please complete this form to request a copy of a certificate from a sacrament you received.
Name on certificate:
*
First Name
Last Name
Name of person requesting certificate:
*
First Name
Last Name
Email of person requesting certificate:
*
example@example.com
Phone Number of person requesting certificate:
*
Please enter a valid phone number.
Where was the sacrament performed?
*
Holy Cross
St. Mary, Star of the Sea
Our Lady of Good Counsel
St. Joseph on Lee St.
Type of sacrament you are requesting a certificate for:
*
Baptism
First Eucharist
Confirmation
Marriage
Funeral
Date of sacrament performed (or approximate)
*
-
Month
-
Day
Year
Date
Date of birth of person named on certificate:
*
-
Month
-
Day
Year
Date
Purpose for request:
*
Where we will send the certificate:
We will mail the certificate within 2 weeks of receipt of this form, often much sooner. Please provide info below, in case we have questions and need to contact the church/tribunal directly. Thank you!
Name of church or tribunal to whom we are sending the certificate:
*
Name of contact person at church/tribunal (if known):
Email of contact person at church or tribunal:
example@example.com
Phone of contact person at church or tribunal:
*
Please enter a valid phone number.
Address of church or tribunal:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Anything else to add?
Submit
Should be Empty: