Current Date
-
Month
-
Day
Year
Date
Baptism Application
Baptism Class Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Are you registering for the November 9th Baptism?
*
Yes
No
Have you filled out a Baptism application?
*
Yes
No
If you have a question about your Baptism application, please call the office at 516 621-3814
Name
*
First Name
Last Name
Email
*
Confirmation Email
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Candidate Info
Baptismal Candidate Info
Candidate Name
*
First Name
Middle Name
Last Name
Suffix
Candidate Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Candidate Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Candidate Email
*
Confirmation Email
example@example.com
Has The Candidate Ever Been Baptized?
*
Yes
No
Are You The Baptismal Candidate?
*
Yes
No
Contact Info
Contact Info
Contact Name
*
First Name
Last Name
Relation To Candidate
*
Parent
Spouse
Other
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Contact E-mail
*
Confirmation Email
example@example.com
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Baptism Class Info
Baptism Class Information
Attending the Baptismal class is an important part of the Baptism process and is mandatoy of all candidates.
The Baptismal class will be via zoom once your application has been approved.
I agree to attend the Baptism Class on the specified date & time.
Yes, I will attend
No, I will not attend
By signing you agree all information submitted here is correct.
*
Submit
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