Baptism Request Form

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Please double-check your entries and use full names.

Surname
Given Names
Month
Day
Year
Place of Birth (City & Province)
First Full Name
Middle Name
Last Name
Religion
First Full Name
Middle Name
Last Name
Religion
Maiden Name

Please enter the address the issued Baptism Certificate will be mailed to.

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This is to prove you are a human and not a computer program filling out our form.