<p> Saint Mary of the Immaculate Conception Parish Faith Formation Office • 330-264-5838</p><p>Pre-Baptismal Registration Form</p><p>______Mother’s Last Name First Middle Maiden </p><p>______Father’s Last Name First Middle </p><p>______Mailing Address City State Zip Code</p><p>______Main Phone Alternate phone number </p><p>______Email Address</p><p>Mother’s religion______Father’s religion ______</p><p>Child’s Birthdate or Due Date ______Place of Birth______If already born ______Child’s Last Name First Middle </p><p>Marriage History Please check ( ) ALL that apply and fill in the blank with which person it applies to:  We are married.  We are not married.  I am a single parent.  I am divorced and remarried. ______ I was previously married. ______ I am widowed or a widower.</p><p>If married, date of marriage ______Minister ______mm/dd/yyyy Name of priest, minister or civil official</p><p>Place of marriage ______Name of church or place Location</p><p>Church Membership Are you registered here at St. Mary? □Yes □No Have you ever been a member of another church? □Yes □No If yes, please list the Church and location:</p><p>______Church City State Saint Mary of the Immaculate Conception Parish Faith Formation Office • 330-264-5838</p><p>Pre-Baptismal Class Have you attended a Pre-Baptismal Class at Saint Mary’s in the last three years? □Yes □No If no, but you have attended a class elsewhere; please provide information about your last class. Catholic Parish______Date:______If you have never attended a class, or have not attended a class in the last three years, classes are offered four times a year. (February, May, August and November)</p><p>Godparents/Christian Witness- (If already chosen, please list. If not, you can provide that information after the Pre-Baptismal Preparation Class). If choosing prior to class, please make sure you have reviewed all guidelines provided and that the Godparents you have chosen are practicing Catholics in good standing.</p><p>Godmother’s name ______Godfather’s name ______</p><p>Phone number ______Phone number ______</p><p>If applicable: Christian Witness______Phone Number______</p><p>Other Children Do any of your children require Sacramental preparation? Yes / No (please make  in  left of name)</p><p> ______(first name) (middle name) (last name) (date of birth) (age) (school) (grade) This child has received:  Baptism  Reconciliation  First Eucharist  Confirmation</p><p> ______(first name) (middle name) (last name) (date of birth) (age) (school) (grade) This child has received:  Baptism  Reconciliation  First Eucharist  Confirmation</p><p> ______(first name) (middle name) (last name) (date of birth) (age) (school) (grade) This child has received:  Baptism  Reconciliation  First Eucharist  Confirmation</p><p> ______(first name) (middle name) (last name) (date of birth) (age) (school) (grade) This child has received:  Baptism  Reconciliation  First Eucharist  Confirmation</p><p> ______(first name) (middle name) (last name) (date of birth) (age) (school) (grade) This child has received:  Baptism  Reconciliation  First Eucharist  Confirmation</p><p>Pre-Baptismal Preparation Questionnaire</p><p>As much as you are comfortable, please describe your faith journey up to this point- Saint Mary of the Immaculate Conception Parish Faith Formation Office • 330-264-5838</p><p>Mother-</p><p>Father-</p><p>In regards to faith, what do you as parents, desire for your child?</p><p>What does Baptism mean to you?</p><p>Briefly describe why you desire Baptism for your child?</p><p>Have you chosen godparents? If so, what is your relationship to them and what are some reasons you chose these godparents?</p><p>*When completed, please return the Pre-Baptismal Registration Form and Questionnaire to the Faith Formation Office. Any questions, please call 330-264-5838.</p>