Record Of Baptism
Please fill out this form and click submit.
Full Name of the Baptized
*
Male / Female
*
Please select all that apply.
Male
Female
Date of Birth
*
Place of Birth (City, State)
*
Please provide your email and phone number. If the person being Baptised is a child under the age of 18 years, provide an email and phone number for one of the parents.
Email
*
This address will receive a confirmation email
Phone
*
Fathers Full Name
*
Mothers Full Maiden Name
*
Baptism Details
Date of Baptism
*
Saints Name
*
Sponsor Information
Orthodox Sponsor (Required)
*
Second Sponsor (Not Required)
Is your second sponsor
Please select all that apply.
Orthodox
Non-Orthodox
Address your Baptism Certificate will be mailed to.
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Service Information
Would you like to arrange or have the church arrange a Chanter?
*
Please select one option.
We will secure a Chanter
The church will secure a Chanter
Select Option
We will secure a Chanter
The church will secure a Chanter
If you are supplying the Chanter, please list the name(s) here.
Would you like to arrange or have the church arrange the Epistle Reader?
*
Please select one option.
We will secure an Epistle Reader.
The church will secure an Epistle Reader.
If you are supplying the Epistle Reader, please list the name(s) here.
Would you like any additional Clergy to be invited? If so, please list them below.
Submit
Description
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