St. Helen Catholic Church

Georgetown

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Baptism Information Request

- Faith Formation

Permission to share baptism information
The maximum number of form submissions has been reached. This form is currently not available.
- Student Information
  
  Date of Baptism (mm/dd/yyyy) REQUIRED
  MONTH/DATE/YEAR MES/FECHA/ANNO
  Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current Grade REQUIRED Please fill out this field. Please enter an integer (number).
- Parent/Legal Guardian Information
  
  Mother's Name (first and last) REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name Please enter valid data.
  
  Father's Name (first and last) Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Email Please enter an email address.
- I understand that this request will be shared with the Faith Formation Office and I will not receive any notice that the information has been shared, nor receive a copy of the certificate.
- I Agree Please select this field.
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