Step 2 | Request a Baptism - St. Luke the Evangelist Catholic Church

Name of Child to be Baptized REQUIRED Please fill out this field. Please enter valid data.

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

Please specify: REQUIRED Male Female Please fill out this field.

Name of Child's Father REQUIRED Please fill out this field. Please enter valid data.

Father's Email Please enter an email address.

Father's Phone Number Please enter a phone number.

Father's Date of Birth: REQUIRED Please fill out this field. Please enter a date.

Please check all that apply regarding the Father: Baptized Confirmed Catholic

Name of Child's Mother REQUIRED Please fill out this field. Please enter valid data.

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

Mother's Phone Number Please enter a phone number.

Mother's Date of Birth: REQUIRED Please fill out this field. Please enter a date.

Please check all that apply regarding the Mother: Baptized Confirmed Catholic

Mailing 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.

Please specify the relationship of the Father and Mother. REQUIRED Married in the Catholic Church. Married civilly by Justice of the Peace. Married in a Protestant service. Married in a non-denominational service. Not married. Other. Please fill out this field.

If you marked "Other," please specify.

If you have other children, please list their names and ages below.

Are you a parishioner of St. Luke? REQUIRED I am a registered parishioner of St. Luke. I am not a registered parishioner of St. Luke. I am unsure. Please fill out this field.

Best Way to Contact You REQUIRED Please fill out this field.