Please choose the mass centre that you attend most often.
Clear selection
Candidate Name: *
The candidate is the person being baptised. If you would like a middle name to appear on the baptism certificate please include in name. Please check all spelling before submitting this form.
Your answer
Is the candidate: *
Candidate Date of Birth: *
MM
/
DD
/
YYYY
Father's Name: *
Please include First Name and Surname
Your answer
Father's Date of Birth:
MM
/
DD
/
YYYY
Father's Religion:
Your answer
Mother's Name:
Please include First Name and Surname
Your answer
Mother's Maiden Name: *
Your answer
Mother's Date of Birth:
MM
/
DD
/
YYYY
Mother's Religion:
Your answer
Email: *
Your answer
Contact Phone Number: *
Your answer
Residential Address: *
Your answer
Suburb: *
Your answer
State: *
Your answer
Postcode: *
Your answer
Postal Address:
If different from Residential Address
Your answer
Suburb:
Your answer
State:
Your answer
Postcode:
Your answer
Date of Baptism: *
MM
/
DD
/
YYYY
Place of Baptism: *
Time of Baptism:
Your answer
Godparent 1 Name (at least one Godparent must be a Catholic):
Your answer
Godparent 1 Religion:
Your answer
Godparent 2 Name:
Your answer
Godparent 2 Religion:
Your answer
Godparent 3 Name:
Your answer
Godparent 3 Religion:
Your answer
Godparent 4 Name:
Your answer
Godparent 4 Religion:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of cairns.catholic.org.au.