Facebook YouTube Email

Request Baptism Certificate

- The maximum number of form submissions has been reached. This form is currently not available.
  
  This certificate is requested for:
  
  Enter the Last Name as it was at the time of Baptism.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  City and State where born Please enter valid data.
  
  Father's Name (First and Last) Please enter valid data.
  
  Mother's Name - First Last (Maiden) Please enter valid data.
  
  Church of Baptism REQUIRED St. Agnes Church St. Athanasius Church Please fill out this field.
  
  Date (or approximate) of Baptism: REQUIRED Please fill out this field. Please enter valid data.
  
  The Baptism certificate will be mailed to you.
  For purpose of Marriage, (or "Convalidation", ie, if already civilly married) the certificate is mailed direct to the Priest/Church with whom you are preparing.
  
  For Wedding - Certificate is mailed to Priest/Church with whom you are preparing for Marriage.
  
  Is Certificate Needed for Your Wedding? REQUIRED Yes No Please fill out this field.
  
  Wedding Date Please enter valid data.
  
  Did you receive either First Communion or Confirmation at St. Agnes or St. Athanasius? If Yes, enter the Sacrament and which Church it was received in, and date (or approximate date).
  
  First Communion or Confirmation?
  
  As part of preparing for the Sacrament of Marriage, couples meet with a member of the clergy to go over preliminary questions (this is different from the "Pre-Cana" class).
  
  Name of Priest with whom you are preparing for Marriage
  
  Priest's Church (include city and state) Please enter valid data.
  
  Priest's Contact Number Maximum 20 characters Please enter a phone number.
  
  Church where Wedding will take place:
  
  Church where wedding will be celebrated Please enter valid data.
  
  Church Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Contact information of person requesting certificate:
  
  Requester's Name (enter First and Last): REQUIRED
  Enter both First and Last name
  Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Street 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.
  
  Any other information you want us to know:
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.