Baptism Application Form – St.Augustine's Parish

Date of Baptism First Choice

Date of Baptism Second Choice

Family Name

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number

Email Address

Child's Name

First

Middle

Last

Date of Birth

Date

Time

Place of Birth (City , Province)

Mother's Name

First

Last

Mother's Maiden Name

Father's Name

First

Last

Mother's Religion

Father's Religion

Marital Status (Married / SIngle / Common Law)

Communion Godmother's First

Mother's Baptism (No / Yes, Church, Province)

Father's Baptism (No / Yes, Church, Province)

Mother had First Communion

Yes
No

Mother had Confirmation

Yes
No

Father had First Communion

Yes
No

Father had Confirmation

Yes
No

Godfather's Name

First

Last

Godfather's Religion

Godfather's Baptism (No/Yes, Church , City, Province)

Godfather's Communion

Yes
No

Godfather's Confirmation

Yes
No

Godmother's Name

First

Last

Godmother's Religion

Godmother's Baptism (No/Yes, Church , City, Province) (copy)

Godmother's Communion

Yes
No

Godmother's Confirmation

Yes
No

Date of Application

Baptismal Prep. Date

Registered in Parish

Yes
No