Baptism Registration Form - St. Rose of Lima

St. Rose of Lima Catholic Church - Newtown Connecticut

Baptism

Baptisms are scheduled on most Sundays at 1:30pm on a first-come basis and based on the availability of St. Rose Church and the clergy. Please contact Roberta Shea at 426-1014 or e-mail her at Stroseadmin@charterinternet.com for additional information, to register for Pre-Baptism class if you have not previously attended, and to confirm the desired date for Baptism.

* Indicates required field

*Name of Child to be Baptized (First, Middle, and Last Name)

Residence (Street, Town, State, Zip)

Telephone Number (Area Code and Phone number)

E-Mail Address

Date of Birth (Month, Day, Year)

Place of Birth (City and State)

Date of Baptism (Sundays at 130 pm)

Father's Name(First, Middle, and Last Name)

Father’s Name(First, Middle, and Last Name)

Religion of Father

Mother's Name (First, Middle, and Last Name)

Mother’s Name(First, Middle, and Last Name)

Mother's Maiden Name

Mother’s Maiden Name

Religion of Mother

Were you married by a Catholic Priest?

Yes

Please select an option

Are you registered at St. Rose?

Yes

Please select an option

Have you attended a Pre-Baptism class?

Yes

Please select an option

Name of Godfather(First, Middle, and Last Name)

Religion of Godfather

Name of Godmother(First, Middle, and Last Name)

Religion of Godmother

Is either Godparent represented by proxy?

Was the child privately baptized?

Yes

Please select an option

Was the child adopted?