Baptismal Registration

St. Joseph Parish – Baptismal Registration

Name of Child (First):

Middle Name:

Family Name:

Address:

City:

ZIP:

Cell Phone:

Home Phone:

Date of Birth:

Place of Birth (City, State):

Father’s Name:

Father’s Religious Affiliation:

Mother’s Name:

Mother’s Maiden Name:

Mother’s Religious Affiliation:

Are the Parents Married?

YesNo

Catholic Marriage?

YesNo

Parish and City of Marriage:

Date of Marriage:

Godparent #1 Full Name:

Godparent #1 Address:

Godparent #1 Parish Name:

Godparent #2 Full Name:

Godparent #2 Address:

Godparent #2 Parish Name:

Desired Date and Time of Baptism:

Additional Notes:

I understand that all required documentation must be submitted at least two weeks prior to the requested baptism date. The baptism date will be confirmed only after all requirements have been fulfilled.