APPLICATION FOR HOLY BAPTISM — intercessionnyc

THE CHURCH OF THE INTERCESSION
New York City

Application for BAPTISM

Date of application

Today's date

MM

DD

YYYY

Name of Person to be Baptized

First Name

Last Name

Gender

Date of Birth

MM

DD

YYYY

PARENTS' INFORMATION

Name of Parent (1)

First Name

Last Name

Work Phone Number of Parent (1)

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Cell Phone Number of Parent (1)

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Email Address of Parent (1)

Church Membership of Parent (1)

Where do you usually attend church services?

Name of Parent (2)

First Name

Last Name

Work Phone Number of Parent (2)

(###)

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Cell Phone Number of Parent (2)

(###)

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Email Address of Parent (2)

Church Membership of Parent (2)

Parents' Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

GODPARENTS' INFORMATION

Name of Godparent (1)

First Name

Last Name

Address of Godparent (1)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Church Membership of Godparent (1)

Name of Godparent (2)

First Name

Last Name

Address of Godparent (2)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Church Membership of Godparent (2)