Holy Baptism Information Form

"*" indicates required fields

Proposed Baptism Date:

Name of Candidate*

First Middle Last

Gender of Candidate:

Date of Birth of Candidate:*

Place of Birth (City, State) of Candidate:

Address of Candidate:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Parent 1:*

First Middle Last

Email of Candidate or Parent 1:*

Phone Number of Candidate or Parent 1:*

Parent 1 Baptized?

Yes

Name of Parent 2:

First Middle Last

Email of Parent 2:

Phone Number of Parent 2:

Parent 2 Baptized?

Yes

Name of Godparent/Sponsor 1:*

First Last

Name of Godparent/Sponsor 2:*

First Last

Name of Godparent/Sponsor 3:

First Last

Name of Godparent/Sponsor 4:

First Last

reCAPTCHA