Baptism Request

Registered in this parish? Yes No

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

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Father's Name REQUIRED Please fill out this field. Please enter valid data.

Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

Mother's First and Maiden Names REQUIRED Please fill out this field. Please enter valid data.

Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

Marital Status REQUIRED Please fill out this field.

Place of Marriage

Please let us know the name and location of the church or if you were married in a civil ceremony.

Please enter valid data.

Date of Marriage Please enter a date.

Primary Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Secondary Phone Number Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

SAINT MARY OF THE