Baptism Request Form

Baptism Request Form
Full Name of the Person Being Baptized*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Place of Birth*

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Religious Background*
Christian Denomination at Baptism
Are you a member of St. Stephen's Episcopal Church Coconut Grove*
Parent 2*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Religious Background*
Christian Denomination at Baptism
Are you a member of St. Stephen's Episcopal Church Coconut Grove*
Sponsor 1*

First NameMiddle NameLast Name
Is this sponsor a Baptized Christian*
Sponsor 2

First NameMiddle NameLast Name
Is this sponsor a Baptized Christian*
Requested Date of Baptism*

The Baptism of our Lord - Sunday, 11 January 2026Easter Vigil (evening service) - Saturday, 4 April 2026Day of Pentecost - Sunday, 24 May 2026All Saints Day - Sunday, 1 November 2026
Should be Empty: