Immaculate Heart of Mary Baptism Request
What is on this form will go on the child's permanent records in the Sacramental Ledger.
Required
Child's Full Name:
*
Required
Boy
Girl
*
Required
Birth Date:
*
Required
City/State:
*
Required
Father's Full Name:
*
Required
Mother's Name (Maiden):
*
Required
Address:
*
Required
Please enter a 10-digit phone number. You can use hyphens or periods to separate numerals, and you can put the area code in parenthesis.
Phone:
*
Required
Please enter a valid email address with the format youraddress@yourdomain.
Email Address:
*
Required
Registered Members:
Yes
No
*
Required
Godfather's Name:
*
Required
Godmother's Name:
*
Date of Baptism:
*
Required
1st Choice:
*
Required
2nd Choice:
*
(Office will check to see if date is available.)
*
Required
Time of Mass:
*
Required
Celebrant:
*
(It is recommended that a donation be given to the priest.)
*