<p> Revised July 2008 Baptism Information Form Please enter or print your information clearly. Please do not use nicknames or initials. Child Information</p><p>Name: Due Date: ( FIRST ) ( MIDDLE ) ( LAST ) ( IF APPLICABLE )</p><p>Male: Female: Birth Date: Birth Place: ( MM/DD/YY ) ( CITY ) ( STATE ) (A COPY OF THE CHILD’S BIRTH CERTIFICATE MUST ACCOMPANY THIS FORM) Parent Information</p><p>MOTHER: ( FIRST ) ( MIDDLE ) ( MAIDEN ) ( LAST )</p><p>Religion: Baptism: ( NAME OF CHURCH ) ( CITY ) ( STATE )</p><p>FATHER: ( FIRST ) ( MIDDLE ) ( LAST )</p><p>Religion: Baptism: ( NAME OF CHURCH ) ( CITY ) ( STATE )</p><p>Address: ( NUMBER & STREET ) ( CITY ) ( ZIP ) ( SUBDIVISION )</p><p>Phone: Email: ( HOME ) ( WORK ) ( CELL ) ( EMAIL ADDRESS )</p><p>Married: ( DATE ) ( NAME OF CHURCH ) ( DENOMINATION ) ( CITY ) ( STATE )</p><p>Registered Parish: Parish ID: ( NAME OF CHURCH ) ( ID NUMBER ) Godparent Information</p><p>At least one Confirmed and practicing Catholic is required. A Catholic who is not in good standing with the Church may not serve as a Christian Witness. Minimum age is 16. At most two are allowed in which case one must be male and the other female. They need not be married to each other. If they are married, they must have been married in the Roman Catholic Church.</p><p>GODFATHER: Email: ( FULL NAME ) ( EMAIL ADDRESS )</p><p>Address: ( NUMBER & STREET ) ( CITY ) ( STATE ) ( ZIP )</p><p>Church He Attends: Religion: ( NAME OF CHURCH ) ( DENOMINATION )</p><p>GODMOTHER: Email: ( FULL NAME ) ( EMAIL ADDRESS )</p><p>Address: ( NUMBER & STREET ) ( CITY ) ( STATE ) ( ZIP )</p><p>Church She Attends: Religion: ( NAME OF CHURCH ) ( DENOMINATION )</p><p>Proxy Godfather: Proxy Godmother: ( FULL NAME - IF NECESSARY ) ( FULL NAME - IF NECESSARY )</p><p>Will the Baptism be celebrated at St. Ignatius Loyola? Yes: No: </p><p>For Church Use Only</p><p>Priest/Deacon: Baptism Date: Certificate Registry Number: Volume: Page: Baptisms cannot be schedules until this form is complete and has been returned to the Worship Office Coordinator and verification of the Baptismal Preparation Classes has been documented. A copy of your child’s birth certificate must be included. Please check our Baptism schedule availability before making any plans. Godparent forms must be returned to the Worship Office at least 10 days prior to the date of the Baptism.</p>