Baptismal Registration

ST. JEAN VIANNEY CHURCH
BAPTISMAL REGISTRATION

* Indicates required field

Child's Full Name *

Male or Female *

Date of Birth *

Place of Birth (City and State) *

Was this child baptized in an emergency or at another church? *

Was this child adopted? *

Father’s Name (First/Middle/Last) *

What Religion Father Baptized: *

Mother’s Name (First/Middle (at birth)/Maiden) *

What Religion Mother Baptized: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Father Email *

Cell:Father *

Cell:Mother *

Mother Email *

Is the Father an active participant in his faith? *

Is the Mother an active participant in her faith? *

Are the parents registered in St. Jean Vianney parish? *

Are the parents identified financial contributors to the parish? *

Are the parents married in the Catholic Church? *

Have the parents attend Baptism prep before? When? Where? *

Godfather’s/Candidates Name (fist/middle/last) *

Baptized / Confirmed Practicing Catholic? *

Registered Church Parish and Address *

Godmother’s/Candidates Name (first/middle/last) *

Baptized / Confirmed Practicing Catholic? *

Registered Church Parish and Address *

To be filled out by Parish Office *

Home Visit Scheduled *

Person doing home visit *

Proposal Date of Baptism *

Mass Time *

How would you like your child baptized? *

Choose One *

Immersion water poured on the head

Submit