Download no children!! - St. Joseph the Worker Catholic Church

BAPTISM INFORMATION
Form Date:
PLEASE READ THIS FORM COMPLETELY BEFORE ENTERING INFORMATION
Please PRINT CLEARLY USING PENCIL-- Por favor SOLO LAPIZ y LETRA de IMPRENT
Please read the baptism brochure. Por favor, lea el folleto el bautismo.
• Return this form completely filled out to the Parish Center.
• Attach a copy of your child’s birth certificate.
• This form must be fully filled out before attending class.
• Class begins at 7:00pm. Class is closed at 7:15pm.
NO CHILDREN!!
-- Desired Baptism Date / Fecha que desea Bautizar -$60.00 Fee Paid …
… English … Spanish … Vietnamese
/
Month/ Mes
/
Day/ Día
Child’s information:
___________________________________________
First Name and Middle Name of Child / Nombre del niño(a)
_______________________________________
______________________________________________________
City of Birth / Ciudad de nacimiento
__________________________________
Date of Birth / Fecha de nacimiento
Last Name / Apellido
________
Age/Edad
Was the child privately baptized because of illness? /¿Fue el niño(a) bautizado(a) antes por motivos de enfermedad? F Yes/Si
Was the child adopted? / ¿Fue el niño(a) adoptado(a)?
F Yes/Si
F No
F No
Parent’s information:
_____________________________________________________
Father’s Name / Nombre del Padre
___________________
Religion / Religión
F Completed Class
/
/
Date
_____________________________________________________
Mother’s first name and maiden name / Nombre de soltera de la madre
___________________
Religion / Religión
F Completed Class
/
/
Date
___________________________________________________________________________________________
Address / Dirección
City/Ciudad
ZIP Code
____________________________
Home Phone / Teléfono de la casa
Work Phone / Teléfono del trabajo
Cell Phone / Teléfono Celular
Were the parents married in the Catholic Church? /¿Se casaron los padres por la Iglesia Católica? F Yes/Si F No
Name of Church/Nombre de la iglesia: ________________________________
In which parish is the family registered? / ¿En qué parroquia están registrados? __________________________________________
If not registered at St. Joseph the Worker; you will need permission from your parish to baptize here.
Si no registrado en esta parroquia; necesitará permiso de su parroquia para bautizar aquí.
Do you have permission to baptize outside of your parish? ¿Tiene permiso para bautizar fuera de su parroquia? F Yes/Si F No
Why are you requesting baptism here? - ¿Por qué pide usted bautismo aquí? ____________________________________________
• Godparents must fill out a Sponsors or Godparents registration form (available in the office)
___________________________________
Godfather’s Name / Nombre del padrino
__________________
Telephone / Teléfono
___________________
Religion / Religión
F Completed Class
/
/
Date
___________________________________
Godmother’s Name / Nombre de la madrina
__________________
Telephone / Teléfono
___________________ F Completed Class
Religion / Religión
/
/
Date
Notes:
FOR OFFICE USE ONLY / SOLO PARA USO DE OFICINA
Schedule Baptism Date:
Actual Baptism Date:
Presiding Priest Name:
Signature:
Date Entered: __________
Page: ___________
No.: ____________
Ledger entry F
Date Certificate Sent: ___________
Date Certificate Made: ___________
FOR OFFICE USE ONLY / SOLO PARA USO DE OFICINA
Call Date: ____________
Interview Date: ____________
Interviewer: ________________________
Interviewer’s Comments: (please enter all comments concerning this baptism here.)
Is this a private baptism?
Yes
No Name of Priest/Deacon performing the baptism ______________________
If not registered at SJW, why is the baptism being done here? ____________________________________________
CLASSES / CLASES
PARENTS / PADRES
will attend class
class waived by: ____________
GODPARENTS / PADRINOS
will attend class
class waived by: ____________
Date attended pre-baptism class / Fecha en que asistieron a clases pre-bautismales
PARENTS / PADRES
FATHER/PADRE
PARISH/PARROQUIA
Date
MOTHER/MADRE
PARISH/PARROQUIA
Date
GODPARENTS / PADRINOS
GODFATHER/PADRINO
PARISH/PARROQUIA
Date
GODMOTHER/MADRINA
PARISH/PARROQUIA
Date
Name of Godparent’s proxy, if any:
FOR OFFICE USE ONLY / SOLO PARA USO DE OFICINA
BAPTISMAL INFORMATION SHEET 060113.doc
6/21/2013 10:49:00