FIRST UNITED CHURCH :: BAPTISM RECORD
Printable Version of Baptism Record Form
Full Legal Name
of Child to be baptized
Gender
Male
Female
Date of Birth
-
January
February
March
April
May
June
July
August
September
October
November
December
-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
1993
1994
1995
1996
1997
1998
1999
2000
2000
2002
2003
2004
2005
2006
2007
2008
2009
2010
Place of Birth
FATHER’S INFORMATION:
Full Legal Name:
Occupation
Religion
Age
Birth Place:
Church Status for Father:
Baptized
Yes
No
Confirmed
Yes
No
Attends Worship
Yes
No
MOTHER’S INFORMATION:
Full Legal Name:
Mother's maiden name
Occupation:
Religion
Age:
Birth Place:
Church Status for Mother:
Baptized
Yes
No
Confirmed
Yes
No
Attends Worship
Yes
No
NAMES & BIRTH DATES OF OTHER CHILDREN
Sponsor (Full Legal Name):
Marital Status of Couple:
Address:
Telephone:
Date of Baptism:
Date of interviews with Minister:
Date Entered in Register:
Date Returns forwarded to Vital Statistics:
Contact Person:
Email Address:
Additional Notes:
