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Baptism Information Form
Date of Baptismal Instruction
*
MM
DD
YYYY
Date of Baptism
*
MM
DD
YYYY
Person to be Baptized
Full Name
First
Middle
Last
Date of Birth
MM
DD
YYYY
Place of Birth
City
State / Province / Region
Sex
Female
Male
Residence
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Parent Information
Parent 1 Full Name
First
Middle
Last
Religious Affiliation
Phone
Email
Parent 2 Full Name
First
Middle
Last
Religious Affiliation
Phone
Email
Godparent/Witness/Sponsor Information
Only one is necessary
#1
First
Middle
Last
#2
First
Middle
Last
#3
First
Middle
Last
Clergy Consulted
Elizabeth Marie Melchionna
Noah Van Niel
Mary Cat Young