Nativity Baptism Form

Please do not use nicknames or abbreviations, as we will use this form to generate the Baptism Certificate

Child's full name:
Child's date of birth:
Born in (City and State) Requested date of Baptism
Home address
City and State Zip code
Home phone number
 
FATHER'S INFORMATION
Name: First Middle Last     
Work phone number Cell phone number E-mail
Religion
 
MOTHER'S INFORMATION
Name: First Middle Last Maiden    
Work phone number Cell phone number E-mail
Religion
 


Are the child's parents married?



Date

Child's parents married in the
Catholic Church?

 
GODPARENT'S INFORMATION
Godfather's Name: First Middle Last
Religion                 
Godmother's Name: First Middle Last
Religion                 
 
Pre-Baptism Class (date you'll be able to attend)
 
If you are not a registered parishioner and would like to be, please fill out the on-line registration form available on our home page.