Our Savior's Lutheran Church of Lafayette, California

BAPTISM INFORMATION
Our Savior's Lutheran Church 1035 Carol Lane, Lafayette, CA 94549

Please complete all the information you can. The information from this form will be used to officially record the baptism in the Parish Register, and to produce a Certificate of Baptism and Certificates of Sponsorship for your use.

Full Name of the Person to be Baptized


First	Middle	Last

Date of Birth


Month	Day	Year

Sex

Place of birth


City	State/Prov	Country

Father's Name


First	Middle	Last

Father's Place of Church Membership

Mother's Name


First	Middle	Last

Mother's Place of Church Membership

Parents' Address


Street	City	State/Prov	ZIP

Parents' Phone Number


Area Code	Phone Number	Email

Please list other children in the family who have been baptized at Our Savior's.

Sponsors'/Godparents' names as you would like them to appear on the certificate.

Preferred Date for the Baptism


Month	Day	Year	Time

If You Prefer a Specific Pastor, Enter His/Her Name

Will the Baptism Be at Our Savior's?

If NO, Where Will the Baptism Take Place?