Baptismal Register Information: ChildName(Required) First Middle Last Birthdate(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Place of Birth (City, State)(Required)Gender(Required) Male Female Was the child adopted?(Required) Yes No Was the child privately baptized?(Required) Yes No Mailing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Phone(Required)Contact Email(Required) Information: FatherFather's Name(Required) First Middle Last Father's Religion(Required)Information: MotherMother's Name(Required) First Middle Last Maiden Name(Required)Mother's Religion(Required)Were the child's parents married by a Catholic priest or deacon?(Required) Yes No Information: GodfatherGodfather's Name(Required) First Middle Last Is the godfather Catholic?(Required) Yes No Name of ParishLocation (City, State)Godmother's Name(Required) First Middle Last Godmother's Maiden NameIs the godmother Catholic?(Required) Yes No Name of ParishLocation (City, State)Will either godparent be represented by a proxy?(Required) Yes No Information: BaptismPreferred Baptism DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Preferred Baptism Time Hours : Minutes AM PM AM/PM Name of PriestAdditional RemarksCommentsThis field is for validation purposes and should be left unchanged.
