BAPTISM APPLICATION FORM

St John’s Anglican Church Albany WA

Details of Children to be Baptised	Date of Application Click or tap to enter a date.

Full Name: Click or tap here to enter text.

Date of Birth: Click or tap to enter a date.

Full Name: Click or tap here to enter text.

Date of Birth: Click or tap to enter a date.

Full Name: Click or tap here to enter text.

Date of Birth: Click or tap to enter a date.

Parents Details:

Mother:

Last Name: Click or tap here to enter text.	First Name: Click or tap here to enter text.

Baptised: Yes ☐ No ☐ Year: Click or tap here to enter text. Place: Click or tap here to enter text.

To which Parish/Church do you belong? Click or tap here to enter text.

How often do you attend church?

Never ☐	Once a year ☐	Once or twice a month ☐	Most Sundays ☐

Mother:

Last Name: Click or tap here to enter text.	First Name: Click or tap here to enter text.

Baptised: Yes ☐ No ☐ Year: Click or tap here to enter text. Place: Click or tap here to enter text.

To which Parish/Church do you belong? Click or tap here to enter text.

How often do you attend church?

Never ☐	Once a year ☐	Once or twice a month ☐	Most Sundays ☐

Address:

Street Address: Click or tap here to enter text.

City: Click or tap here to enter text. State: Click or tap here to enter text. Postcode: Click or tap here to enter text.

Home Phone: Click or tap here to enter text.Work Phone: Click or tap here to enter text.

Mobile: Click or tap here to enter text. Email: Click or tap here to enter text.

Godparents:

NB: It is usual to have two Godfathers and one Godmother for a male child and two Godmothers and one Godfather for a female Child. If godparents are not able to be present at the service, the parents of the child or some other person can act as proxy. Godparents must be members of the Christian Church.

Full Names: Click or tap here to enter text.

Address: Click or tap here to enter text.

Baptised: Yes ☐ No ☐ Year: Click or tap here to enter text. Place: Click or tap here to enter text.

Signature of Godparent:

Full Names: Click or tap here to enter text.

Address: Click or tap here to enter text.

Baptised: Yes ☐ No ☐ Year: Click or tap here to enter text. Place: Click or tap here to enter text.

Signature of Godparent:

Full Names: Click or tap here to enter text.

Address: Click or tap here to enter text.

Baptised: Yes ☐ No ☐ Year: Click or tap here to enter text. Place: Click or tap here to enter text.

Signature of Godparent:

Mother’s Signature	Father’s Signature

Please Note: The personal information you provide on this form will not be handed out, in accordance with Australian privacy laws. It will be used by the Anglican Parish of Albany to consider your application for baptism and to correspond with yourselves. The information will be kept in the Parish’s database and accessed by authorised Church personnel only.