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Baptism Information Form

- Baptism Information Form
  
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  Name of Child REQUIRED Please fill out this field. Please enter valid data.
  
  Gender Female Male
  
  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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Religion of Father REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Religion of Mother REQUIRED Please fill out this field. Please enter valid data.
  
  In what church were parent's married ? REQUIRED Please fill out this field. Please enter valid data.
  
  Godfather's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Is the Godfather a Catholic ? REQUIRED Please fill out this field. Please enter valid data.
  
  Godmother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Is the Godmother a Catholic ? REQUIRED Please fill out this field. Please enter valid data.
  
  Will either Godparent be represented by Proxy ? REQUIRED No Yes Please fill out this field.
  
  Was the child privately baptized No Yes
  
  Was the child adopted No Yes
  
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Church of Immaculate Heart of Mary

Scarsdale, NY

Baptism Information Form

Baptism Information Form