Request Form for the Sacrament of Baptism

Request Form for the Sacrament of Baptism

This form is to used to prepare the baptismal certificate. Please fill out in its entirety.
Today's Date*

MonthDayYear
Date
Full Name of Child*

First NameMiddle NameLast Name
Date of birth*

MonthDayYear
Date
Place of birth (City and State are required)*
Was child previously baptized previously?*

YesNo
If you answered "Yes" to your child being previously baptized, please tell us where this took place.
Name of Mother:*

First NameLast Name
Name of Father*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Phone Number*
Please enter a valid phone number.
Father's Phone Number*
Please enter a valid phone number.
Mother's Email*
example@example.com
Father's Email*
example@example.com
Mother's Religion*
Father's Religion*
Are the mother and father married?*

YesNo
Living together*

YesNo
Date of marriage

MonthDayYear
Date
Name and Location of church of marriage
If you were not married in the Church, do you plan to have your marriage convalidated?

YesNo
Do you attend Mass at IHM?*

YesNo
If yes, are you registered with the parish?

YesNo
If yes, how long have you been members at IHM?
If no, where are you parishioners at?
Why are you seeking Baptism at IHM?*
How often does the Mother attend Mass?*

NeverOnce a month3 times a monthAlwaysOther
How often does the Father attend Mass?*

NeverOnce a month3 times a monthAlwaysOther
Do you receive the sacrament of Confession regularly? Mother:*

YesNo
Do you receive the sacrament of Confession regularly? Father:*

YesNo
Have you attended a Baptism class at IHM Parish?*

YesNo
If yes, when?
Number of children:*
Please provide the names, dates of birth, and sacraments received of children attending IHM school:
Christianne Brussdelman, in her book Religion for Little Children, describes the home as "the most important classroom," meaning that the example of having a lived fath that your child witnesses in you is the most influential teaching anyone can provide. How do you personally practice your faith in the home?*
What does it mean to you to be the primary educator of your child's faith? How do you intend to nurture your child's faith life by building up the Domestic Church in your home?*
Godparents
Godparents are persons who themselves have been baptized, confirmed, and receive the Eucharist. They are active, participating members of the Catholic Church, willing and able to share their faith with the child. Godparents must be at least 16 years old. You may choose a practicing Christian of another faith to serve as a witness at the ceremony, but you must choose at least one Catholic Godparent. If you choose two Godparents/Witnesses, one must be male and one female.
Godfather/witness:*

First NameMiddle NameLast Name
Religion of godfather*
Godmother/witness:*

First NameLast Name
Religion of godmother:*
Should be Empty:

Request Form for the Sacrament of Baptism

Godparents