Baptism Request Form

Baptism Request Form

Please provide your details to request a baptism.
Full Name of Person to be Baptized*

First & Middle NameLast Name
Date of Birth*

MonthDayYear
Date
City of Birth*
State of Birth*
MaleFemale
Upload a Copy of the Birth Certificate

Accepted formats: PDF, JPG, PNG
Cancelof
YesNo
Father's Name*

First NameLast Name
Father's Religion*
Mother's Name*

First NameLast Name
Mother's Religion*
Main Contact's Phone Number*
Format: (000) 000-0000.
Main Contact's Email Address*
Home Address*

Street Address

Street Address Line 2
CityStateZip CodeCountry
YesNoNot sureNot yet, but we'd like to be
Baptism Details
YesNo
If yes, who would you prefer?
If no, then the available Priest or Deacon will perform it.
Preferred Baptism Date

MonthDayYear
Date
During Saturday 4:00pmAfter Saturday 4:00pmDuring Sunday 9:00amAfter Sunday 9:00am
Godparents

** At least one Godparent must be a Confirmed Practicing Catholic. **
Godparent #1
Name

First NameLast Name
Confirmed Practicing CatholicWitness
Godparent #2
Name

First NameLast Name
Confirmed Practicing CatholicWitness
Parish databaseSacramental bookBulletin announcement
Should be Empty:

Baptism Details