Baptism Registration Form

Child's Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Place of Birth (city, state) REQUIRED Please fill out this field. Please enter valid data.

Is your child... REQUIRED Male Female Please fill out this field.

Father's Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.

Is Father Catholic? REQUIRED Yes No Please fill out this field.

If no, what is father's religion? Please enter valid data.

Mother's Name (first, middle, maiden) REQUIRED Please fill out this field. Please enter valid data.

Is Mother Catholic? REQUIRED Yes No Please fill out this field.

If no, what is mother's religion? Please enter valid data.

Parents' Names as they should appear on the baptismal certificate (certificate will be mailed) REQUIRED Please fill out this field. Please enter valid data.

Home 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. Please enter valid data.

ZIP Code REQUIRED Please fill out this field. Please enter valid data.

Primary Phone (555-123-4567) REQUIRED

Please fill out this field. Please enter a phone number.

Secondary Phone (555-123-4567)

Please enter a phone number.

Email Address (either parent) REQUIRED Please fill out this field. Please enter an email address.

Need to attend Baptism Preparation Class? REQUIRED Yes No (attended class in last three years) Please fill out this field.

Relationship to Gesu parish? REQUIRED Registered Parishioner Territorial Parishioner, i.e., live in the area Current Marquette student non-Parishioner Please fill out this field.

Sponsor Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.

First Sponsor Religion - must be a confirmed, practicing Catholic REQUIRED Please fill out this field. Please enter valid data.

Second Sponsor Name (first, middle, last) REQUIRED Please fill out this field. Please enter valid data.

Second Sponsor Religion - must be a Christian REQUIRED Please fill out this field. Please enter valid data.