Baptism Registration Form
If you have any questions please contact Jenny Binsfeld at Jbinsfeld@kaucp.org | 920-766-1445 x119
Child's Birth Status
*
Not born yet
Born
Child's Name
First Name
Middle Name
Last Name
Child's DOB
-
Month
-
Day
Year
Date
City and State of Birth
Child's Gender
Female
Male
Mother's Full name
*
First Name, Middle Name
Last Name
Mother's Previous Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Full Name
First Name, Middle Name
Last Name
Father's Previous Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Other Children's name, Age and gender?
Preferred Date of Baptism
-
Month
-
Day
Year
Date
Preferred Church for Baptism
Holy Cross
St. Katharine Drexel Parish - St. Mary's Church
St. Katharine Drexel Parish - St. Francis Church
Preferred Time of Baptism
Preferred Priest or Deacon
Any will be good for us
Father Luke Ferris
Father Sudha Sivvam
Deacon Hank Wildenberg
Deacon Randy Haak
Other
Godmother name
First Name
Last Name
Fully initiated Catholic?
Yes
No
Godfather name
First Name
Last Name
Fully initiated Catholic?
Yes
No
Christian witness name (if applicable)
First Name
Last Name
Christian witness name (if applicable)
First Name
Last Name
No Baptism stipend is suggested, but you are free to make an offering of your choice.
-KCP
Preferred Church for Baptism
Visit Complete
Yes
No
Preferred Priest or Deacon
Submit
Should be Empty: