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  • Please complete this form to request a child be baptized.
  • Child To Be Baptized
    • Child Last Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Child First Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Child Middle Name Maximum 25 characters Please enter valid data.
    • Sex REQUIRED (Select One) Female Male Please fill out this field.
    • Child Date of Birth REQUIRED Please fill out this field. Please enter a date.
    • Town/City of Birth REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • State REQUIRED Maximum 2 characters Please fill out this field. Please enter valid data.
    • Already Baptized REQUIRED

      Due to Emergency was child baptized already?

      (Select One) No Yes Please fill out this field.
    • Baptized Location Maximum 25 characters Please enter valid data.
  • Mothers Information
    • Mothers Last Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Mothers First Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Mothers Middle Name Maximum 25 characters Please enter valid data.
    • Mothers Maiden Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Mothers Email Address Maximum 50 characters Please enter valid data.
    • Mothers Religion REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
  • Fathers Information
    • Fathers Last Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Fathers First Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Fathers Middle Name Maximum 25 characters Please enter valid data.
    • Fathers Email Address Maximum 50 characters Please enter valid data.
    • Fathers Religion REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
  • Family Information
    • Street Address REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
    • Town/City REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
    • State REQUIRED Maximum 2 characters Please fill out this field. Please enter valid data.
    • ZIP Code REQUIRED Maximum 10 characters Please fill out this field. Please enter valid data.
    • Primary Phone REQUIRED Maximum 15 characters Please fill out this field. Please enter valid data.
    • Secondary Phone Maximum 15 characters Please enter valid data.
    • Are Parents Married? REQUIRED (Select One) Yes No Please fill out this field.
    • Parents Married by Catholic Priest REQUIRED

      If not married, birth certificate required

      (Select One) Yes No Please fill out this field.
    • Have You Registered Your Family in St Michael Parish? REQUIRED (Select One) Yes No Please fill out this field.
    • Date of Baptism Prep Class Please enter a date.
  • Godmothers Information
    • Godmothers Last Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Godmothers First Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Godmother's Street Address REQUIRED Please fill out this field. Please enter valid data.
    • Godmother's City/Town REQUIRED Please fill out this field. Please enter valid data.
    • Godmother's State REQUIRED Please fill out this field. Please enter valid data.
    • Godmother's Zip Code REQUIRED Please fill out this field. Please enter valid data.
    • Godmothers Email Address REQUIRED Maximum 50 characters Please fill out this field. Please enter valid data.
    • Phone # REQUIRED Maximum 50 characters Please fill out this field. Please enter valid data.
    • Godmothers Religion REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
  • Godfathers Information
    • Godfathers Last Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Godfathers First Name REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
    • Godfather's Street Address REQUIRED Please fill out this field. Please enter valid data.
    • Godfather's City/Town REQUIRED Please fill out this field. Please enter valid data.
    • Godfather's State REQUIRED Please fill out this field. Please enter valid data.
    • Godfather's Zip Code REQUIRED Please fill out this field. Please enter valid data.
    • Godfathers Email Address REQUIRED Maximum 50 characters Please fill out this field. Please enter valid data.
    • Phone # REQUIRED Maximum 50 characters Please fill out this field. Please enter valid data.
    • Godfathers Religion REQUIRED Maximum 25 characters Please fill out this field. Please enter valid data.
  • Proxy Information
    • This section is usually not needed
    • Proxy Last Name Maximum 25 characters Please enter valid data.
    • Proxy First Name Maximum 25 characters Please enter valid data.
    • Proxy Middle Name Maximum 25 characters Please enter valid data.
    • Proxies Email Address Maximum 50 characters Please enter valid data.
    • Proxy Religion Maximum 25 characters Please enter valid data.
  • Comments
    • Provide any comments you wish to add
    • Comments

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