Request for Baptism/Confirmation - Saint Miriam Parish & School

This is a request for... *BaptismSacrament for Confirmation

Please Note:

Adult baptisms are also confirmed at the same time. No additional request is needed. Children must be “of age“ no younger than 12 years old and must have completed Sacramento preparation or received a waiver from the pastor in order to be confirmed.

Requested Date *

Prefix

First Name *

Middle Name

Last Name *

Phone Number *

Email Address *

I am the candidate's ... *Parent or GuardianSponsorOther

Candidate Information

First Name *

Middle Name

Last Name *

Candidate's Age Range *Child (Minor)Adult

Date of Birth *

Place of Birth *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Denomination(if applicable)

Parents and Sponsors

Name of Parent #1 *

Marital Status

If you were married by a priest from Saint Miriam, could you please enter their name here:

BaptisedYesNo

Denomination(if applicable)

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone Number *

Email Address *

Name of Parent #2

Marital Status

If you were married by a priest from Saint Miriam, could you please enter their name here:

BaptisedYesNo

Denomination(if applicable)

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Phone Number

Email Address

Name of Godparent or Sponsor

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Name of Godparent or Sponsor

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Please let us know if you have any questions!