Baptism

BAPTISM REGISTRATION

Registered Members of: REQUIRED St. Olaf - DeForest St. Joseph- East Bristol St. Jerome - Columbus St. Joseph - Rio St. Patrick - Doylestown St. Thomas - Poynette Not Registered at any location Please fill out this field.

Must be registered with one of our parishes - go to https://nativitylord.org/join-our-parish.

Year Registered (if known) Please enter valid data.

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.

Child's Information

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

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

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

Gender REQUIRED Male Female Please fill out this field.

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

Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.

Adopted? REQUIRED Yes No Please fill out this field.

Parent 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.

Parent's Married in the Catholic Church? REQUIRED Yes No Please fill out this field.

Name of Church REQUIRED Please fill out this field. Please enter valid data.

Year Married REQUIRED Please fill out this field. Please enter valid data.

Have parents previously attended a baptism prep course? REQUIRED Yes No Please fill out this field.

If yes, where and when? Please enter valid data.

Any special circumstances we need to be aware of? Please explain: Please enter valid data.

Father's Information

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

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

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

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

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Confirmed Catholic? REQUIRED Yes No Please fill out this field.

Mother's Information

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

Mother's Middle 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.

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

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

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Confirmed Catholic? REQUIRED Yes No Please fill out this field.

Godparent Information

Godfather's Name (First & Last) REQUIRED Please fill out this field. Please enter valid data.

Church of Baptism REQUIRED Please fill out this field. Please enter valid data.

Confirmed Catholic? REQUIRED Yes No Please fill out this field.

Church of Confirmation REQUIRED Please fill out this field. Please enter valid data.

Godmother's Name (First & Last) REQUIRED Please fill out this field. Please enter valid data.

Church of Baptism REQUIRED Please fill out this field. Please enter valid data.

Confirmed Catholic? REQUIRED Yes No Please fill out this field.

Church of Confirmation REQUIRED Please fill out this field. Please enter valid data.

Additional Comments