Baptismal Request Form

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

Gender REQUIRED Male Female Please fill out this field.

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

Place of Birth (City, State) REQUIRED Please fill out this field. Please enter valid data.

Father's Information

Full Name REQUIRED Please fill out this field. Please enter valid data.

Father's Religion REQUIRED Please fill out this field. Please enter valid data.

Baptized REQUIRED Yes No Please fill out this field.

First Eucharist REQUIRED Yes No Please fill out this field.

Confirmation REQUIRED Yes No Please fill out this field.

Mother's Information

Full Name REQUIRED Please fill out this field. Please enter valid data.

Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Religion REQUIRED Please fill out this field. Please enter valid data.

Baptized REQUIRED Yes No Please fill out this field.

First Eucharist REQUIRED Yes No Please fill out this field.

Confirmation REQUIRED Yes No Please fill out this field.

Are Parents Married? REQUIRED Yes No Please fill out this field.

If yes, by a Catholic Priest or Deacon? REQUIRED Yes No Please fill out this field.

Home 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.

Home Phone Please enter a phone number.

Father's Work Phone Please enter a phone number.

Father's Cell Phone Please enter a phone number.

Mother's Work Phone Please enter a phone number.

Mother's Cell Phone Please enter a phone number.

Preferred Phone to Reach You REQUIRED Please fill out this field. Please enter a phone number.

Preferred Email REQUIRED Please fill out this field. Please enter an email address.

Godparents' Information

Godfather's Name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Faith REQUIRED Please fill out this field. Please enter valid data.

Has Godfather been Confirmed? REQUIRED Yes No Please fill out this field.

Godmother's Name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Faith REQUIRED Please fill out this field. Please enter valid data.

Has Godmother been Confirmed? REQUIRED Yes No Please fill out this field.

The email address you'd like us to send your confirmation receipt to. REQUIRED Please fill out this field. Please enter an email address.

additional Requirements

*Godparents must be verified by their parish, stating they are confirmed Catholics and in a sacramental marriage, if married.

*Parents and Godparents must participate in baptismal classes at St. Monica or their own parish.

I Understand These Requirements Please select this field.

I understand that in order to reserve a date for the Baptism the Godparent Eligibility Form (which can be downloaded from this page) and the child's birth certificate must first be received by the parish office.

I Understand Please select this field.

Sacramental Fee100.0

St. Monica Church

1001 Camino Pablo, Moraga, CA 94556
925-376-6900

Baptismal Requests

Contact Us

Baptismal Request Form

Father's Information

Mother's Information

Godparents' Information

additional Requirements