Baptism Form | The Chapel of the Cross of Chapel Hill, NC

Baptism Information Form

Date of Baptism *

Person to be Baptized:

Name *

First

Middle

Last *

Last

Date of Birth *

Sex

Male

Female

Place of Birth *

City

Place of Birth – State *

State / Province / Region

Residence

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Parent 1 Information:

Full Name

First

Middle Name

Middle

Last Name

Last

Religious Affiliation

Phone

Parent 2 Information:

Full Name

First

Parent 2 Middle Name

Middle

Parent 2 Last Name

Last

Religious Affiliation

Phone

Godparent/Witness/Sponsor Information:

Only one is necessary.

Repeater

Name

First

Witness Middle Name

Middle

Witness Last Name

Last

Add Person Remove Person

Clergy Information:

Clergy Consulted

Elizabeth Marie Melchionna

Noah Van Niel

Mary Cat Young

OtherOther

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