Please note that all Baptismal certificates will note any other sacraments received as they are noted in our baptismal register.

Name of Baptized

First Name

Last Name

Date of Birth

MM

DD

YYYY

Year of Baptism (or profession of faith)

Mother's Maiden Name

Email

Phone Number

(if we need more information)

(###)

###

####

Are you a parishioner at St. Mary's?

Yes

No

If not, please indicate the parish where you are currently a member:

When would you like the certificate delivered by?

MM

DD

YYYY

Where would you like the certificate to be mailed?

Name of person requesting certificate

First Name

Last Name

Baptism Certificate Form