Baptismal Application

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Desired Date of Baptism

Date

Time

Name of Candidate for Baptism

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Place of Birth

City, State

Date of Birth

Phone

Father's Name

First

Last

Father's Faith

Mother's Name

First

Last

Mother's Faith

Does the baptismal candidate have a godfather?

Phone

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