Reading Catholic Community

Saint Agnes Parish, 184 Woburn St, Reading MA 01867
Saint Athanasius Parish, 300 Haverhill St, Reading MA 01867

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Baptism Request Form

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- Child to be baptized information:
- Child's FULL Name (First-Middle-Last) REQUIRED Please fill out this field. Please enter valid data.
- Child's Gender REQUIRED Female Male Please fill out this field.
- Child's Date of Birth mm/dd/yyyy REQUIRED Please fill out this field. Please enter a date.
- Child's City, State of Birth REQUIRED Please fill out this field. Please enter valid data.
- Is this your first child to be baptized? REQUIRED Please fill out this field.
- Family Contact Information:
- My family is a member of: REQUIRED Please fill out this field.
- I wish to register my family as members of: St. Agnes St. Athanasius
- Street 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.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Comments:
- Mother's FULL Name (First-Middle-Last) REQUIRED Please fill out this field. Please enter valid data.
- If this is your first child to be baptized, parents are required to attend the Parent Baptism Meeting. Parent Meetings are held on the First Friday of every month at the St. Agnes Parish Center
- Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
- Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Full Name (First-Middle-Last) REQUIRED Please fill out this field. Please enter valid data.
- Father's Religion REQUIRED Please fill out this field. Please enter valid data.
- Godfather's FULL Name Please enter valid data.
- Godfather's Religion Please enter valid data.
- Godmother's FULL Name Please enter valid data.
- Godmother's Religion Please enter valid data.
- Use this space for any additional Information you wish us to know
  Use this space for any additional information you wish us to know.
  Please enter valid data.
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