Pre Baptismal Information Form Page 3

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Shelby___ Date_____ Birth Cert___ Pd._____ Int.____
Today’s Date:
Scheduled Date of Baptism
Scheduled Date of Seminar
(completed by office)
Baptism Time & Presider:
Please Print All Names Clearly for the Baptism Certificate:
Child’s Name:
First
Middle
Last
Date of Birth:
Place of Birth:
City
State
If expecting, date baby due:
Was the child adopted?
If yes, is the adoption process final?
Attach documents.
Father’s Name:
First
Middle
Last
Address:
Street
City
State
Zip
Phone #: Work
Home
Cell
Religion:
Email:
Mother’s Name:
First
Middle
Last
Full Maiden Name:
Address:
Street
City
State
Zip
Phone #: Work
Home
Cell
Religion:
Email:
Godparent Information: If you are uncertain of the Godparents information, submit this form anyway and update at a later time.
Religion:
Godfather’s Name:
Has the godfather been Baptized, Confirmed, and made his First Communion in the Catholic Church?
Is he a practicing Catholic?
If not Catholic, what Christian denomination is he a practicing member?
Religion:
Godmother’s Name:
Has the godmother been Baptized, Confirmed, and made her First Communion in the Catholic Church?
Is she a practicing Catholic?
If not Catholic, what Christian denomination is she a practicing member?

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