Baptism Request Form

Parental Information

Please let us know the name of the mother and father of the child to be baptized as well as contact information.

First Name Please enter valid data.

Last Name Please enter valid data.

First Name Please enter valid data.

Last Name Please enter valid data.

Address 1 REQUIRED Please fill out this field. Please enter valid data.

Address 2

Please use this for an apartment number or other necessary address addition.

Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Contact Email Please enter an email address.

Whose contact information is this? Mother Father Other (please Specify)

Additional Contact Person Information

If you checked "other", please let us know the name and relation of the contact.

Please enter valid data.

Please let us know about the child(ren) to be baptized.

Number of Children to be Baptized REQUIRED Please fill out this field.
Child 1
- Name of Child
  Please tell us the name of your child. First and middle name are best.
  Please enter valid data.
- Sex of Child REQUIRED Male Female Please fill out this field.
Child 2
- Name of Child
  Please tell us the name of your child. First and middle name are best.
  Please enter valid data.
- Sex of Child REQUIRED Male Female Please fill out this field.
Child 3
- Name of Child
  Please tell us the name of your child. First and middle name are best.
  Please enter valid data.
- Sex of Child REQUIRED Male Female Please fill out this field.
Child 4
- Name of Child
  Please tell us the name of your child. First and middle name are best.
  Please enter valid data.
- Sex of Child REQUIRED Male Female Please fill out this field.