Baptism Registration Form Welcome to St. Andrew Roman Catholic Church. Please fill out the Baptism registration form. If you have any questions regarding this form, please call us at 954-752-3950. Thank you! I am completing this registration form*to have my child Baptized at St. Andrew.because I need to complete a Baptismal class to be a Godparent.because I am having my child baptized at another parish and need to complete a Baptismal class.Do you wish to have the Baptism in English or Spanish?*EnglishSpanishDo you want to attend the class in English or Spanish?*EnglishSpanishDo you prefer to attend the class that is in English or Spanish?*EnglishSpanishWho will be attending the baptismal class?* Mother Father Godmother Godfather Please mark all that apply.Child's Full Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Child's Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Place of Birth: Name of City*Place of Birth: Name of County*Place of Birth: State (Name of country if born outside United States)*Age of Child*Is the child adopted?*YesNoEnvelope # (Registered Parishioners Only)Father's Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Name Middle Name Last Name Suffix Mother's Maiden Name Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Name Middle Name Maiden Name Suffix Married?YesNoIf Married, where? (Name of Church? City?)If not married by church - please type civilly)Address* Street Address Apartment Number City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Telephone*Secondary TelephoneEmail Godfather* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Marital Status*SingleMarriedWidowedDivorcedCommon Law (Living Together)If Married, where? (Name of Church? City? Country?)*Please type civil - if only married by court.What is the name of the church that the Godfather currently attends?Envelope Number (St. Andrew Parishioner only)Primary Telephone NumberSecondary Telephone NumberGodmother Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix What is the name of the church that the Godmother currently attends?Envelope Number (St. Andrew parishioner only)Marital Status*SingleMarriedWidowedDivorcedCommon Law (Living Together)If Married, where? (Name of Church? City? Country?)*Please write N/A if not married. Primary TelephoneSecondary TelephoneAre Godparents represented by proxy?YesNoIf yes, what are the Proxy names?Is Baptism at Saint Andrew?*YesNoIf not, where? (Please give name of church and location)*NameThis field is for validation purposes and should be left unchanged.