Baptism Information Form

Is this your first child to be baptized at St. Stephen? REQUIRED Yes No Please fill out this field.

Child's First Name REQUIRED Please fill out this field. Please enter valid data.

Child's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Child's Last Name REQUIRED Please fill out this field. Please enter valid data.

Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.

Child's Gender REQUIRED Male Female Please fill out this field.

City of Birth REQUIRED Please fill out this field. Please enter valid data.

State of birth REQUIRED Please fill out this field. Please enter valid data.

Father's Full Name REQUIRED Please fill out this field. Please enter valid data.

Father's Faith REQUIRED Please fill out this field. Please enter valid data.

Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Mothers' Faith REQUIRED Please fill out this field. Please enter valid data.

Family Contact Information

Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Contact Phone Number (10 digits, no dashes) ie. 7083422400 REQUIRED Please fill out this field. Please enter a phone number.

Contact Email REQUIRED Please fill out this field. Please enter an email address.

Married REQUIRED Yes No Please fill out this field.

GODPARENT INFORMATION

Godparent 1 Full Name REQUIRED Please fill out this field. Please enter valid data.

Godparent 1 Catholic? Yes No

Godparent 2 Full Name REQUIRED Please fill out this field. Please enter valid data.

Godparent 2 Catholic? Yes No

Are you a registered parishioner of St. Stephen? REQUIRED Yes No. Please fill out this field.

St. Stephen Deacon and Martyr