THE CHURCH OF THE INTERCESSION
New York City

Application for BAPTISM


Date of application
Date of application
Today's date
Name of Person to be Baptized
Name of Person to be Baptized
Date of Birth
Date of Birth
PARENTS' INFORMATION
Name of Parent (1)
Name of Parent (1)
Work Phone Number of Parent (1)
Work Phone Number of Parent (1)
Cell Phone Number of Parent (1)
Cell Phone Number of Parent (1)
Where do you usually attend church services?
Name of Parent (2)
Name of Parent (2)
Work Phone Number of Parent (2)
Work Phone Number of Parent (2)
Cell Phone Number of Parent (2)
Cell Phone Number of Parent (2)
Parents' Address
Parents' Address
GODPARENTS' INFORMATION
Name of Godparent (1)
Name of Godparent (1)
Address of Godparent (1) *
Address of Godparent (1)
Name of Godparent (2)
Name of Godparent (2)
Address of Godparent (2)
Address of Godparent (2)