Request a Baptism

Desired dates are not finalized until confirmed by the secretary. Once the baptism request has been received, the secretary will contact you.

Desired Date (#1) Please enter a date.

Desired Date (#2) Please enter a date.

Desired Parish St. Mary's St. Helena's

Email Please enter valid data.

Call back number Please enter a phone number.

First, Middle and Last Name of Person to be Baptized Please enter valid data.

Gender Male Female

Date of Birth Please enter a date.

Hospital of Birth Please enter valid data.

Home Address Please enter valid data.

Mailing Address (if different) Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Father's Full Name (First, Middle and Last) Please enter valid data.

Mother's Full Name (First, Middle and Last) Please enter valid data.

Mother's Maiden Name Please enter valid data.

Parents, have you had any instruction on the sacrament of baptism from Fr. Zimmer or another priest? Yes No Not sure

Please note: at least one Godparent must be a Catholic sponsor. See "Godparent Recommendation Form" below for details.

Godfather's Name Please enter valid data.

Is he Catholic? Yes, he is Catholic. No, he is not Catholic.

Godmother's Name Please enter valid data.

Is she Catholic? Yes, she is Catholic. No, she is not Catholic.

St. Mary Catholic Church