Baptism Online Form Date of Application (MM/DD/YYYY) Full Name of Person to be Baptized Address Street Address Address Line 2 City State Postal / Zip Code Country Age at Baptism Date of Birth (MM/DD/YYYY) Place of Birth Father's Full Name Mother's Full Name Parents' Residence (if different from above) Phone Number Email (optional) Religious Affiliation of Father Religious Affiliation of Mother Witnesses or Godparents (Please Name at Least Two) First Godparent's/Witness' Name Address Street Address Address Line 2 City State Postal / Zip Code Country Second Godparent's/Witness' Name Address Street Address Address Line 2 City State Postal / Zip Code Country Third Godparent's/Witness' Name Address Street Address Address Line 2 City State Postal / Zip Code Country Date of Baptism (MM/DD/YYYY) Time of Service ---8:00 am10:30 amNoon Place of Baptism Officiant ---The Rev. K. Paul St. GermainThe Rev. Christopher C. RichardsonOtherNo Preference