HOLY BAPTISM

Information For Church Records And Certificates

1. Full name of person to be baptized: ______________ ______________ ______________

2. Address: __________________________________________________________________

3. City/State/Zip: _____________________________________________________________

4. Phone: _____ ____________________

5. Birth date (month/day/year): __________ __________ __________

6. Birth place (City/State): ____________________ ____________________

7. Father's full name: ______________ ______________ ______________

8. Address & Phone (if different than # 2 above):

9. Mother's full name: ______________ ______________ ______________

10. Mother’s maiden name: ____________________

11. Address & Phone (if different than #2 above):

12. First and Last names of Sponsors (Godparents): ____________________________________________________________

____________________________________________________________

13. Date, time and location of baptism: ______________ ______________ ______________

14. Special Notes:

15. For families living out of the area: Name and address of the Lutheran congregation to which a Letter of Transfer can be sent for the newly baptized: