Our Lady of Perpetual Help Church
Request for Infant/Young Child Baptism
Proposed Baptism Date
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Date
Family Name
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Date
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Child's information
First Name
Middle
Last
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Date of Birth
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Day
Year
Date
City State
Parents
First
Middle
Last
Religion
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Maiden Name
Religion
Godparents
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Middle
Last
Religion
First
Middle
Last
Religion
Birth Certificate
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Clergy you would like to perfom the Baptims
Please Select
Dcn. Mark Silvia
Dcn. Dennis O’Neil
Dcn. Daniel Ramos
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Baptism
Baptism, Baptism Seminar for Parents and Godparents
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
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