Baptism Registration

St. Mary Parish, Oskaloosa

Parent Information:

Father’s Full Name

Is Father Catholic?

If No, then what religion?

Mother's Full Name

Maiden Name:

Is Mother Catholic?

If No, then what religion?

Address

City, State, Zip

Phone:

Home, Work, Cell

Is the marriage of the parents recognized valid within the Church?

Are the parents registered members of St. Mary Parish, Oskaloosa?

If not St. Mary Parish, Oskaloosa, what parish/where?

Child Information:

Name of Child (First, Middle, Last):

Date of Birth:

Sex of Child: Male/Female

Place of Birth:

Was this child adopted?

Was this child already baptized?

Sponsor Information

If only one sponsor; Full Name:

If two sponsors:

Godfather’s Full Name: (The Godfather must be a baptized, Confirmed, and Eucharist receiving Catholic)

Godmother's Full Name: (The Godmother must be a baptized, Confirmed, and Eucharist receiving Catholic)

Christian Witness Full Name:

Are Any of the above to be represented by a proxy?

If yes, then which and by whom?

Baptism:

Requested Date:

Time

With in Mass/Outside of Mass