Request for Baptism
Full Name of Child to be Baptized
Your answer
Date of Birth
MM
/
DD
/
YYYY
Place of Birth
(City, State)
Your answer
Full Name of Father
(First Middle Last)
Your answer
Religion of Father
Your answer
Full Name of Mother
(First Middle Last)
Your answer
Maiden Name of Mother
Your answer
Religion of Mother
Your answer
Full Name of Godfather
(If unsure, Please say "Will Notify")
Your answer
Religion of Godfather
Your answer
Full Name of Godmother
(If unsure, Please say "Will Notify")
Your answer
Religion of Godmother
Your answer
Date Requested for Baptism
MM
/
DD
/
YYYY
During or After the following mass...
Requested Administrator of Baptism
Contact Person
Your answer
Telephone Number
Your answer
Email Address
Your answer
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