Baptism date requested*
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Parents Class date requested (if required):
Thursday, October 11, 2018 6:30-7:45pmSaturday, October 27, 2018 1:00-2:15pmThursday, November 8, 2018 6:30-7:45pmSaturday, November 17 1:00-2:15pmSaturday, December 1, 2018 1:00-2:15pmThursday, December 13, 2018 6:30-7:45pmSaturday, January 10, 2019 1:00-2:15pmThursday, January 19, 2019 6:30-7:45pmSaturday, February 7, 2019 1:00-2:15pmSaturday, February 16, 2019 1:00-2:15pmThursday, March 7, 2019 6:30-7:45pmSaturday, March 23, 2019 1:00-2:15pmThursday, April 11, 2019 6:30-7:45pmSaturday, April 27, 2019 1:00-2:15pmSaturday, May 2, 2019 6:30-7:45pmThursday, May 25 1:00-2:15pmThursday, June 6, 2019 6:30-7:45pmSaturday, June 22, 2019 1:00-2:15pmThursday, July 11, 2019 6:30-7:45pmSaturday, July 27, 2019 1:00-2:15pm

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: