Baptism Information Form

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Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Are you registered parishioners at Sacred Hearts Parish? Please check if yes? Please select this field.
Address Please enter valid data.
Address Line 2 Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Email REQUIRED Please fill out this field. Please enter an email address.
Home Phone Please enter valid data.
Check if home phone is unlisted. Please select this field.
Mom Cell Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Dad Cell Phone Maximum 20 characters Please enter a phone number.
Child's Full Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.
Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
City and State of child's birth REQUIRED Please fill out this field. Please enter valid data.
Child is our
Is the child a student at Sacred Hearts School or Early Childhood Center? Yes No
Is the student part of our RCIC program? REQUIRED Yes No Please fill out this field.
Mother's Full Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.
Mother's maiden name (if different from above) Please enter valid data.
Mother's Religion Please enter valid data.
Father's Full Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.
Father's Religion Please enter valid data.
Marital Status REQUIRED Please fill out this field.
For married couples, were you married by a:
For married couples, date and place of marriage Please enter valid data.
Godmother's full name (first, middle, last) Please enter valid data.
Godmother's Religion (please note: at least one of the Godparents must be a baptized and confirmed Catholic who practices the faith. In addition to this, a baptized non-Catholic Christian may serve as a Christian witness.) Please enter valid data.
Godfather's full name (first, middle, last) Please enter valid data.
Godfather's Religion (please note: at least one of the Godparents must be a baptized and confirmed Catholic who practices the faith. In addition to this, a baptized non-Catholic Christian may serve as a Christian witness.) Please enter valid data.
Is either Godparent to be represented by a proxy (i.e. unable to attend the baptism in person?) Please check if yes. Please select this field.
Are there any special circumstances (e.g. child was already baptized in an emergency, child is adopted)?
Please tell us about your and your child's baptism preparation (please check all that apply); Parents have attended the one-hour baptism instruction class at Sacred Hearts within the last 3 years. Parent will plan to take the one-hour baptism prep class prior to the child's baptism Child has attended RCIC (not applicable for infants) Child is planning to attend RCIC (not applicable for infants) Other

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