Request for Baptism

If the candidate for Baptism is a child, are there any Court Orders in place? If so, does the person requesting this Baptism have legal authority to do so? (If Court Orders are in effect, these will need to be sighted by the priest at the first meeting) *Please fill the required field.

First Name of candidate for Baptism *Please fill the required field.

[if applicable] Middle / Baptismal name of candidate

Surname of candidate for Baptism *Please fill the required field.

Sex of Candidate (required for idenfication if candidate requests information later in life)Please fill the required field.

Date of Birth of candidate for Baptism *Please fill the required field.

Preferred Date for Baptism (leave blank if yet to be determined)

Residential address of candidate for Baptism *Please fill the required field.

Email (if a child: of the main caregiver/contact person) *Please fill the required field.

Phone number (if a child: of the main caregiver/contact person)Please fill the required field.

Mother's / Caregiver 1's name (first and surname) *Please fill the required field.

Mother's / Caregiver 1's religion *Please fill the required field.

Mother's / Caregiver 1's main occupation *Please fill the required field.

Father's / Caregiver 2's name (first and surname) *Please fill the required field.

Father's / Caregiver 2's religion *Please fill the required field.

Father's / Caregiver 2's main occupation *Please fill the required field.

Who is the contact person / main caregiver (if the candidate for Baptism is a child/infant)?

1st Godparent's full name: *Please fill the required field.

1st Godparent's religion: *Please fill the required field.

2nd Godparent's full name (if applicable):

2nd Godparent's religion:

3rd Godparent's full name (if applicable):

3rd Godparent's religion:

Any additional details (if applicable) *Please fill the required field.

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1 + 1 = ?

Anglican Parish of Innisfail-Tully

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