Baptism date requested (if required):
Sunday, January 13Sunday, January 27Sunday, February 10Sunday, March 3Sunday, April 7Sunday, April 28Sunday, May 19Sunday, May 26Sunday, June 9Sunday, June 23Sunday, July 14Sunday, July 21Sunday, August 4Sunday, August 18Sunday, August 25Sunday, September 8Sunday, September 15Sunday, September 29Sunday, October 13Sunday, October 27Sunday, November 10Sunday, November 17Sunday, December 1Sunday, December 15Sunday, December 29

Parents Class date requested (if required):
Saturday, September 14 1:00-2:15pmThursday, September 26 6:30 -7:45pmSaturday, October 12 1:00-2:15pmThursday, October 24 6:30 -7:45pmSaturday, November 9 1:00-2:15pmThursday, November 14 6:30-7:45pmSaturday, December 7 1:00-2:15pmThursday, December 19 6:30-7:45pm

Number attending class:

Person/Child to be Baptized:

Name of Person/Child (first, middle, last):

Sex: FemaleMale

Date of Birth: 12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 201420152016201720182019202020212022202320242025

City of Birth:

Father Information:

Name of Father (first, last)*:

Is the Father Catholic?*: YesNo

Mother Information:

Maiden Name of Mother (first, last)*:

Is the Mother Catholic?*: YesNo

Address*

City, State, Zip Code*

Phone Number*

Email *:

Godfather Info:

Name of Godfather:*

Is the Godfather Catholic?: YesNo

If not Catholic, what faith is the godparent?

Godmother Info:

Name of Godmother: *

Is the Godmother Catholic?*: YesNo

If not Catholic, what faith is the godmother?

General Info:

Are you a registered member of Holy Name Cathedral Parish?* YesNo

How many guests do you expect?*

Was the child privately Baptized?* YesNo

Were the parents married by a priest or a deacon?* YesNo

Does the child have any siblings?* YesNo

Comments or Questions: