After submitting this form, our staff will be in contact with you using the contact information given. 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 GodparentsGodfather's Full Name* Godmother's Full Name* Requested Baptism Date* MM slash DD slash YYYY Please upload a copy of the birth certificateMax. file size: 100 MB.
