Concord-Carlisle Catholic Collaborative
Holy Family & St. Irene

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Baptism Request Form

- Sacraments

Please complete and submit this form to request a baptism for the next schedule date or another date. Please be prepared to share the following information:
- Baptismal Date
- Parents' Info
- Child's Info
- Godparents' Info
Baptism Request Form
This form is not accepting responses at this time.
- Registered to our parish? REQUIRED Yes No Please fill out this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter an integer (number).
- Street Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Baptismal Date Requested REQUIRED Please fill out this field. Please enter a date.
- Normal Baptism Schedules:
  First Sunday at 1PM - Holy Family Parish
  Third Sunday at 1PM - St. Irene's Parish
- Parents' Information
- Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.
- Mother's Full Name (Maiden) REQUIRED Please fill out this field. Please enter valid data.
- Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.
- Marital Status REQUIRED Please fill out this field.
- Date/place of parents' Marriage REQUIRED Please fill out this field. Please enter a date.
- Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Secondary Phone Number Maximum 20 characters Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Child's Information
- Child's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Place of Birth REQUIRED Please fill out this field. Please enter valid data.
- Godparents' Information
- At least one Godparent must be Catholic and have received the Sacrament of Confirmation.
- Godfather
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Is Godfather a confirmed Catholic? REQUIRED Yes No Please fill out this field.
- Religious Affiliation Please enter valid data.
- Godmother
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Is Godmother a confirmed Catholic? REQUIRED Yes No Please fill out this field.
- Religious Affiliation Please enter valid data.
- I, as the parent/guardian, acknowledge that this information will be submitted to the parish for use in registration if applicable.
  Parental Confirmation Please select this field.
Submit

Baptism Request Form

Parents' Information

Child's Information

Godparents' Information

Godfather

Godmother