Baptism Request – Immaculate Conception Parish

Baptism Request

Please enter all spaces in the form and submit.

Baptism Request Form

Child's Full Name*
Child's Sex*
- Female
- Male
Child's Date of Birth*
YYYY slash MM slash DD
Child's Place of Birth*
Requested Date of Baptism*
YYYY slash MM slash DD
Location of Baptism
Older Siblings who are Baptised?
- Yes
- No
Father's Name*
Father's Religion*
Mother's Name (Maiden)*
Mother's Religion*
Name of Church where Parents were Married*
Parents Address*
Street Address Address Line 2 City Province Postal Code
Telephone #*
Email*
Enter Email Confirm Email
God Parent's Name & Religion*
God Parent's Name & Religion
God Parent's Name & Religion
God Parent's Name & Religion
NOTES