EmailMe Form - Pre-Baptismal Form

TODAY'S DATE: *

MM / DD / YYYY

Family Name: *

Father's Name *

First Middle Last Suffix

Father Catholic? *

Yes

No

Mother's Name *

First Middle Last

Mother's Maiden Name *

First Last

Mother Catholic? *

Yes

No

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Registered at OLSH? *

Yes

No

Church of Marriage: *

FULL NAME OF CHILD TO BE BAPTIZED: *

First Middle Last

Please give Child's FULL name as it appears on Birth Certificate. No initials

Gender *

Male

Female

Date of Birth: *

MM / DD / YYYY

Place of Birth: (City, State)

Was Child privately baptized?

Yes

No

If privately baptized, where?

Does Child have a handicapping condition?

Yes (complete next box)

No

Handicapping Condition:

GODFATHER'S NAME *

First Last

GODFATHER'S PARISH: *

Letter of Recommendation Submitted on:

GODMOTHER'S NAME: *

First Last

GODMOTHER'S PARISH: *

Letter of Recommendation Submitted on:

Any Comments

OFFICE USE ONLY:

Please DO NOT complete the information below - this is for the Parish Office ONLY.

Date & Time of Baptism:
(Please note - No date will be scheduled until Letters of Recommendation are in the Parish Office & Baptismal Class is completed)

MM / DD / YYYY HH : MM AM/PM

Where will Baptism take place?

Church

Chapel

Minister of Baptism:

Active Parishioner:

Yes

No

Baptismal Class completed?

Yes

No

Godparents Letters of Recommendation Completed?

Yes

No

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Signature

Clear