After submitting this form, our staff will be in contact with you using the contact information given. "*" indicates required fields Contact Name* First Last Contact Email* Contact Phone Number*ChildChild's Name* First Middle Last Child's Date of Birth* MM slash DD slash YYYY Child's Place of Birth* ParentsFather's Full Name* Mother's Full Name* Parent's Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are the parents members of Our Lady of Loretto Church?* Yes No What is the parents envelope number? If you don't know the parents envelope number, then please contact the parish office at (516) 489-3675GodparentsGodfather's Full Name* Godmother's Full Name* Requested Baptism Date* MM slash DD slash YYYY Preferred Language for Baptism* Spanish English Baptisms in Spanish take place every second and fourth Sunday at 2:30pm, and in English every second Sunday of the month at 4:00pm.Please upload a copy of the birth certificateMax. file size: 100 MB.
