Baptism Information Form

This information is needed to properly record your child's Baptism in the Baptismal Register and to prepare the sacramental certificate. St. Andrew's, as the church of your child's Baptism, will continue to record all of their sacraments. This form should be submitted to the Church at least one week before the baptism.

Child's full name REQUIRED Please fill out this field. Please enter valid data.

M or F REQUIRED Please fill out this field.

Child's date of birth REQUIRED Please fill out this field. Please enter a date.

Child's place of birth (city and state) REQUIRED Please fill out this field. Please enter valid data.

Date of Baptism requested REQUIRED Please fill out this field. Please enter a date.

If requested date is during a weekend Mass, which Mass would you prefer? 5:30 pm Saturday 11:30 am Sunday

Date of Baptism Preparation class REQUIRED Please fill out this field. Please enter a date.

Email REQUIRED Please fill out this field. Please enter an email address.

Are you currently registered parishioners of St. Andrew's Church? REQUIRED Please fill out this field.

If you are not registered at St. Andrew's but would like to be, please visit our quick and easy online registration HERE.

Father's full name REQUIRED Please fill out this field. Please enter valid data.

Father - check which sacraments you have received REQUIRED Baptism Reconciliation / Penance First Holy Communion Confirmation Matrimony / Marriage Please fill out this field.

Mother's full name REQUIRED Please fill out this field. Please enter valid data.

Mother's MAIDEN name REQUIRED Please fill out this field. Please enter valid data.

Mother - check which sacraments you have received REQUIRED Baptism Reconciliation / Penance First Holy Communion Confirmation Matrimony / Marriage Please fill out this field.

Parent's Street address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Daytime Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Catholic Godparents must complete the GODPARENT ATTESTATION FORM, available from the Church or on our website. Form must be submitted to St. Andrew's BEFORE the baptism takes place.

Godfather's full name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

Godmother's full name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

After you click "SUBMIT", you should receive a confirmation email. If you do not receive an email, please contact Kathy Boyer at kboyer@standrewsva.org.