Name *

First Name

Last Name

Phone Number *

(###)

###

####

What Sacraments have you completed? *

Baptism

First Reconciliation

First Communion

Confirmation

Marriage

None of the Above

Baptism:

I was baptized Catholic

I was baptized Christian

Other

Date I was baptized

MM

DD

YYYY

I received my First Reconciliation.

Yes

No

I received my First Communion.

Yes

No

Date I received First Communion

MM

DD

YYYY

Baptismal Certificate: PICK ONE...

I was baptized at Holy Cross, and you already have a copy of the certificate in your records.

My child was NOT baptized at Holy Cross; I will send a digital copy (photo or scanned copy) of the baptismal certificate to Jerica.

I need help with this; please contact me.