Baptism Registration

Please fill out all the required fields and click SUBMIT button when done.  The Church office will contact you to confirm the Baptismal date and time.  Thank you!

First, Middle, Last name
Name
  •  
Choose One
List (Single Choice)
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Street Address
Address
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Phone number
Phone --
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Date of Birth
Date //
  •  
Place of Birth (City & State)
Text (Single Line)
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Date of Baptism (To be confirmed)
Date //
  •  
Father's Name
Name
  •  
Religion of Father
Text (Single Line)
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Mother's First & Maiden Name
Text (Single Line)
  •  
Religion of the Mother
Text (Single Line)
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In what church were parents married
Text (Single Line)
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Godfather's Name (First & Last)
Name
  •  
Is the Godfather a Catholic
List (Multiple Choice)
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Godmother's Name (First & Last)
Name
  •  
Is the Godmother a Catholic
List (Multiple Choice)
  •  
Is either Godparents represented by Proxy
List (Multiple Choice)
  •  
Remarks
Text (Multiple Lines)
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