Baptism Request

Request for Holy Baptism

Please provide the following information about the candidate for baptism. If you prefer a paper form, please contact the parish staff by calling 804.288.2867. For a list of Baptism dates and times, please visit the Baptism page. Once you have submitted this form, you will hear from a member of the parish staff within a week.

Desired Baptism Date(Required)

(see list of dates on Baptism page)

Time(Required)

Where do you wish to have the candidate baptized?(Required)

The main church

Palmer Hall

No preference

Please identify baptism candidate type(Required)

Infant

Child

Adult

Candidate's Name(Required)

First Middle Last Suffix

City and state of birth(Required)

Date of Birth(Required)

Gender(Required)

Parents

Parent 1 Name(Required)

First Middle Last Suffix

Parent 2 Name

First Middle Last Suffix

Parent 1 church membership

Parent 2 church membership

Residence (Include city, state, and zip)(Required)

Telephone (home)

Parent 1 (mobile)(Required)

Parent 2 (mobile)(Required)

Best Email(Required)

Enter Email Confirm Email

Godparents

Godparent 1

First Middle Last

Godparent 2

First Middle Last

Godparent 3

First Middle Last

Godparent 4

First Middle Last

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