Adult Baptism

Please complete this form and submit at least 4 weeks before the sacrament

Sacrament Information

Date of Baptism

YYYY

Schedule Time of Baptism

Hour

Minute

Second

Adult Information

Name as it appears on Birth Certificate

Baptismal Name

Current Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Place of Birth (City & State)

Date of Brith

YYYY

Parent's Information

Father's Name

Father's Place of Birth (City & State)

Mother's Name (including Maiden Name)

Mother's Place of Birth (City & State)

Godparent(s) Information

The Godparent(s) MUST be an Orthodox Christian(s) in good standing with his/her parish. If the Godparent(s) is (are) a member of another Orthodox parish, the parish Priest must send us a letter in Good Standing, at least 10 days before the Baptism, stating that the Godparent(s) is (are) a member in good standing, both spiritually and financially. (Has been married in the Orthodox Church, or if divorced, has received an Ecclesiastical Divorce, etc.)

Godparent(s) Legel & Baptismal Name

Members of which Parish (Church Name along with City & State)

Godparent(s) Marital Status

Single

Married

Divorced

Widowed