Pre-Baptismal Questionnaire
All information that you submit to us is kept secure and confidential
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Child's Name
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Gender
Female
Male
Child's Birth Date
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Child's Birth Month
January
February
March
April
May
June
July
August
Sept
Oct
Nov
Dec
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Birth Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
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Birth Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
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Where Born? (city,state/province and country)
Parent Information
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Father's Name
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Father's Religion
Catholic
Lutheran
Presbyterian
Methodist
Baptist
Other Christian
Non-Christian
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Mother's Name
Mother's Maiden Name
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Mother's Religion
Catholic
Lutheran
Presbyterian
Methodist
Baptist
Other Christian
Non-Christian
Contact Info
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Address
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City
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State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
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ZIP
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Home Phone
Work or other phone
Email address
Godparents- There must be at least one Catholic Godparent who is a baptized, confirmed and practicing Roman Catholic. If there are two Godparents (Catholic) there must be one Godmother and one Godfather, not two Godmothers or two Godfathers. Christian Witnesses- If one of your "Godparents" is not Catholic, then he or she is a Christian Witness, who is also welcome to stand by the Baptismal Font during the Baptism.
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How many Godparents do you have as sponsors for your child?
1 Godparent (Catholic)
2 Godparents (both Catholic, one male and one female)
1 Godmother(Catholic) and 1 or more Christian Witness (Non-Catholic)
1 Godfather (Catholic) and 1 or more Christian Witnesses
2 Godparents (Catholic) and one or more Christian Witnesses (Non-Catholic)
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Indicates Response Required