PLEASE FILL OUT THIS FORM AND UPLOAD A COPY OF THE CHILDS BIRTH CERTIFICATE YOUR CHILDS FULL NAME ON SUBJECT LINE THIS FORM. PLEASE HAVE ALL FAMILY AND FRIENDS ARRIVE 15 MINUTES PRIOR TO SCHEDULED TIME PLEASE MAKE SURE THE BABY IS DRESSED BEFORE THE BAPTISM BEGINS PLEASE BRING A KLEELA AND A SMALL TOWEL THE DAY OF BAPTISM THERE IS NO FEE FOR BAPTISM, BUT ANY AND ALL DONATIONS ARE GREATLY APPRECIATED GOD BLESS YOU AND YOUR FAMILY ALWAYSChild Full Name(Required) First Middle Last Child Baptismal Name if different from middle name First Date of Baptism(Required) MM slash DD slash YYYY Time of Baptism Hours : Minutes AM PM AM/PM Gender(Required) Male Female Date of Birth(Required) MM slash DD slash YYYY Place of Birth - Hospital and City(Required) Father's Full Name(Required) First Last Father's Religion(Required) Chaldean Catholic Other Mother's Maiden Full Name(Required) First Last Mother's Religion(Required) Chaldean Catholic Other Cell Phone Number(Required)Email Address(Required) Home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Godfather First and Last Name First Last Godfather - Age (Must Be 14 Years or Older) Is the Godfather Catholic? Yes No Other Godmother First and Last Name First Last Godmother - Age (Must Be 14 Years or Older) Is the Godmother Catholic? Yes No Other (IF EITHER PARENT IS A NON-CHALDEAN CATHOLIC) IS IT YOUR DESIRE TO HAVE YOUR CHILD FORMALLY PART OF THE CHALDEAN CATHOLIC CHURCH? Yes No Birth Certificate Drop files here or Select files Max. file size: 10 MB. If you do not have the birth certificate you can email it to secretary@holymartyrsccc.org later Δ
