Baptism Contact Form

Please fill out the Baptism Registration Form and

Name of Child

First Name*

Middle Name

Last Name*

Residence

Street 1*

Street 2

City*

State*

Zip*

Date of Birth

Required* //

Place of Birth

Required*

Preferred Date of Baptism

Required* //

Please note: This date is based on availability of Father Phil. We will confirm by phone that this date is available.

Phone

Required* --

Required*

Father's Name

First Name*

Middle Name

Last Name*

Last, First, & Middle

Religion of Father

Required*

Mother's Maiden Name

First Name*

Middle Name

Last Name*

Religion of Mother

Required*

Were the Parents Married by a Catholic Priest?
Required*

yes

Name of Godfather

First Name*

Last Name*

Is Godfather a Catholic?
Required*

yes

Name of Godmother

First Name*

Last Name*

Is Godmother a Catholic?
Required*

yes

Is either Godparent represented by Proxy?
Required*

yes

Was the child privately baptized?
Required*

yes

Was the child adopted?
Required*

yes

Name of Celebrant

Title

First Name*

Last Name*

Time of Baptism

Required* :

Parish where Baptism is to take place
Required*

St. Joseph

St. Vincent

Will the Baptism be at Mass or Privately?
Required*

At Mass

Privately