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Baptism Request Form

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- Child's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Baptismal Date/Time REQUIRED
  This is the date you are requesting. Please enter a couple of dates in the order of preference.
  Please fill out this field. Please enter valid data.
- Birth Date REQUIRED Maximum 15 characters Please fill out this field. Please enter valid data.
- City of Birth REQUIRED Please fill out this field. Please enter valid data.
- Father's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Religion REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
- Mother's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name REQUIRED Please fill out this field. Please enter valid data.
- Religion REQUIRED Maximum 20 characters Please fill out this field. Please enter valid data.
- Street 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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Registered in the Parish REQUIRED Yes No Please fill out this field.
- Baptism Class Completed REQUIRED Yes No Please fill out this field.
- Date Completed Please enter a date.
- Location class was completed at Please enter valid data.
- Godparent's Name
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Religion Maximum 20 characters Please enter valid data.
- Godparent's Name
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Religion Maximum 20 characters Please enter valid data.
- Remarks
Submit

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Our Lady Queen of Peace

Grafton, OH

Baptism Request Form