REQUEST FOR BAPTISM CERTIFICATE
Fields marked with a red asterisk must be completed
APPLICANT'S DETAILS
Title
*
Name
*
Address Details
*
Please provide your email address
*
This is required so that you can be contacted when the Baptism Certificate is available to collect
Please enter a Contact Phone Number
*
Please enter a valid Mobile or Landline Number
Your Relationship to the Baptised Person
What is Your Relationship to the Baptised Person
Self
Parent
Guardian
Other
Details of Baptised Person
Full Name at Baptism
*
Date of Birth
*
/
Day
/
Month
Year
Place of Baptism
*
Our Lady of The Assumption Church Newcastle
St. Patrick's Church Bryansford
Date of Baptism
*
/
Day
/
Month
Year
If unsure, please give an approximate date
Parents Details
Father’s Full Name
*
Mother’s Full Maiden Name
*
Purpose of Certificate
What is the Purpose of Certificate?
*
Confirmation
Wedding
School Admission
Personal Records
Other
Baptism Certificates Required for a Wedding
This section must be completed if the Baptism Certificate is required for a Wedding otherwise move to next section
Location of Wedding
Date of Wedding
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Month
-
Day
Year
Please note Baptism Certificates MUST be dated within 6 months of the proposed wedding date
Type of Baptism Certificate Required
What Type of Certificate is Required?
*
Standard Baptism Certificate
Baptism Certificate with Annotations (Confirmation / Marriage)
Delivery Preference
How would you like to receive the Baptism Certificate
*
By Post (Please Note: This option will incur a Postage Fee)
Collect in the Parish Office
Declaration
I confirm that the information provided above is accurate to the best of my knowledge. I understand that baptismal records are confidential and certificates are issued in accordance with Church guidelines.
Signature of Applicant (Please Sign the the box below)
*
Date
*
-
Month
-
Day
Year
Date
Submit Form
Submit Form
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