Baptism Questionnaire

Child's Name

First Name

Last Name

Child's Date of Birth

MM

DD

YYYY

Child's Place of Birth (City, State, Country)

Father's Name

First Name

Last Name

Father's Religion

Mother's Maiden Name

First Name

Last Name

Mother's Religion

Parent's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone

(###)

###

####

Email

Godfather's Name

First Name

Last Name

Godfather's Religion and Attending Church

Godmother's Name

First Name

Last Name

Godmother's Religion and Attending Church

Proposed Date for Baptism

MM

DD

YYYY

Proposed Time for the Baptism