BAPTISM INFORMATION FORM

Please fill out this form and click submit.

Please make sure that the spelling of all names is correct, as this is how the names will be printed on the Baptism Certificate, as well as the Service of Baptism bulletin you will receive on the day of the Baptism.

Person to be Baptized

First Name

*

Middle Name

*

Last Name

*

Month, Day & Year of Birth

*

City and State of Birth

*

Requested date(s) for Baptism (PLEASE NOTE, we need to review the requested date(s) to make sure it is available. We will let you know.)

*

First and Last Names of all Godparents/Sponsors (if known at this time)

Primary Parent Contact Info

Name

*

Address

*

Phone

*

The phone # is my

*

Please select one option.

Cell Phone Landline

Email

*

This address will receive a confirmation email

Are you a Member of Alleluia?

*

Please select one option.

Yes No

Have you attended Baptism classes in the past?

*

Please select one option.

Yes No

If you have attended a Baptism class, when and where?

Names and ages of siblings that will be present at the baptism, if applicable

Secondary Parent Contact Info

Name

*

Address if different from Above

Phone

*

The phone # is my

*

Please select one option.

Cell Phone Landline

Email

*

Are you a member of Alleluia?

*

Please select one option.

Yes No

Additional Comments or Messages

Description

Please fill out this form and click submit.

Please Fix the Following

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