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Email
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Full Name of Child
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Date of birth
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DD
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YYYY
Place of birth
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Male or Female
Male
Female
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Have you had a child baptized at Holy Innocents before?
Yes
No
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Home mailing address (where the certificate will be sent)
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Phone number
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Legal Name of Father
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Religion of father
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Legal Name of Mother (+ maiden name)
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Religion of mother
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In what church were parents married?
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Godfather's name
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Is the godfather a practicing Catholic who has received the Sacrament of Confirmation?
Yes
No
Not sure
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Godmother's name
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Is the godmother a practicing Catholic who has received the Sacrament of Confirmation?
Yes
No
Not sure
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Is either godparent represented by a proxy?
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Was the child adopted?
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Are you committed to raising the child Catholic and bringing him/her to Mass every Sunday?
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No
Maybe
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Name of minister doing the baptism, if known
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Desired date of baptism
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DD
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YYYY
Remarks
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