Baptism Form - Sacred Heart Coshocton

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Baptism Request Form

Please note that filling out this form does not guarantee a requested date for a Baptism. Someone from the Parish staff will call to follow up on your request and finalize the date.

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Father's Name *

Father's Religion *

Mother's Name *

Mother's Religion *

Are Parents Married? *

Yes
No

If married, were they married in the Catholic Church? *

Yes
No

Have the parents attended a Baptism course at Sacred Heart within the last 3 years? *

Yes
No

Street Address *

City *

State *

Zipcode *

Phone Number *

Name of Child *

Gender of Child *

Male
Female

Date of Birth *

Place of Birth *

Requested Date of Baptism *

Second Choice Date of Baptism *

Name of Godfather *

Is Godfather Catholic? *

Yes
No (Christian Witness)

Name of Godmother *

Is Godmother Catholic? *

Yes
No (Christian Witness)

Will Godparent(s) be represented by proxy?

Yes
No

Name(s) of proxy/proxies

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