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

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

—Please choose an option—8:00 am10:30 amNoon

Place of Baptism

Officiant

—Please choose an option—The Rev. K. Paul St. GermainThe Rev. Christopher C. RichardsonOtherNo Preference