Baptism Form

Baptism Request form

* Indicates required field

Name of Child *

Gender *

Male Female

Street Address *

City *

State *

Zip Code *

Phone Number *

Date of Birth *

Place of Birth *

Requested Date of Baptism *

Second Choice of Date of Baptism *

PARENT & GODPARENT INFO

Father's Full Name *

Mother's Full Maiden Name *

Religion of Father *

Religion of Mother *

Are parents married? *

Yes No

If married, were parents married in the Catholic Church? *

Yes No

Godfather *

Godmother *

Godfather Catholic? *

Yes No (Christian Witness)

Godmother Catholic? *

Yes No (Christian Witness)

Is either Godparent represented by proxy? *

Yes No

Name of Proxy(s) *

Submit

Immaculate Conception Dennison