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

Person to be Baptized