Baptism Application Form Please fill out this form in order to apply for a baptism at The Basilica of St Mary Star of the Sea. Child InformationName of Child(Required) First Last Date of Birth(Required) MM slash DD slash YYYY Place of Birth(Required)City, State (*Please bring birth certificate) Child's Address(Required) Street Address Address Line 2 City State 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 ZIP Code Preferred Date of Baptism(Required) MM slash DD slash YYYY Preferred Language(Required) Is child adopted?(Required) Yes No Was the child privately baptized?(Required) Yes No Parental InformationFather's Name(Required) First Last Mother's Name(Required) First Last Parental Contact Email(Required) Enter Email Confirm Email Parental Contact Phone(Required)Best Time To Call YouWhen is the best time for us to reach you via telephone?MorningsEarly AfternoonLate AfternoonEarly EveningFather's Religion Mother's Religion Are the parents married?(Required) Yes No Were the parents married by a Roman Catholic Priest?(Required) Yes No What Catholic Church do you attend?(Required) Godparent InformationGodfather's Name First Last Godfather's Religion Godmother's Name First Last Godmother's Religion Is either godparent represented by proxy?If yes, please provide the name of the proxy. Yes No Name of proxy First Last Any additional informationCommentsThis field is for validation purposes and should be left unchanged. Δ