Catholic Parishes of Adams & Cheshire - Baptism Intake Form

Preliminary Baptism Information

Which one of our locations are you looking to schedule a Baptism at?

Notre Dame Church St. Stanislaus Kostka Church St. Mary of the Assumption Church

What is the approximate date you are hoping to schedule the Baptism for?

Child Information

Please enter your child's information here.

In some cases, families are looking to have multiple children Baptized at the same time. If this applies to you, you may complete the additional child section. Otherwise, please skip those fields.

Child's First Name

Child's Middle Initial or Middle Name

Child's Last Name

Child's Date of Birth

Child's City and State of Birth

Additional Child's Name (First, Middle, Last)

Additional Child's Date of Birth & Place of Birth

Additional Child's Nam (First, Middle, Last)

Additional Child's Date of Birth & Place of Birth

Father Information

Please complete all fields if applicable.

Father's First Name

Father's Middle Initial or Middle Name

Father's Last Name

Address

This address will receive a confirmation email

Cell Phone

Are you Catholic? Yes No (Please list faith below)

If not Catholic, what faith?

Mother Information

Please complete all fields if applicable.

Mother's First Name

Mother's Middle Initial or Middle Name

Mother's Last Name

Mother's Maiden Name

Address (if different from Father's address)

This address will receive a confirmation email

Cell Phone

Are you Catholic? Yes No (Please list faith below)

If not Catholic, what faith?

Legal Guardian Information

Only complete this section if there is no mother or father listed above or if the legal guardian is seeking Baptism but chooses to list the biological parents.

Legal Guardian's First Name

Legal Guardian's Middle Initial or Middle Name

Legal Guardian's Last Name

Address

This address will receive a confirmation email

Cell Phone

Family Information

Parishioner Status

Parishioner - St. John Paul II (Adams) Parishioner - St. Mary's (Cheshire) Non-Parishioner - (We live in the area and will need to register with the parish.) Non-Parishioner - (We live outside the area but are seeking this church for Baptism.)

Date of Parent's Marriage (if applicable)

Name of Church and Location of Marriage (if applicable)

Prospective Godparents

One Godparent must be a Confirmed, practicing Catholic. The other may be a Christian Witness of another denomination.
If you are unsure about who the Godparents will be, please leave this section blank.

Prospective Godparent's Full Name

Godparent's Parish

Prospective Godparent's Full Name

Godparent's Parish

All families and Godparents must meet with the parish priest or deacon to prepare for Baptism. Acceptance of this form is for planning purposes. If you do not receive a response to this form submission within 7 days, please call the parish office at 413-743-2110.

Description

Please complete this Baptism Intake Form to start the process of planning a Baptism. Once you have completed the form, click the submit button at the bottom. We will review your completed form and get in touch with you to start the planning process.

For additional Baptism information, including the checklist, Godparent regulations, and more, please visit: https://acparishes.org/baptism.

Rev. Fr. Michael Lillpopp
Pastor
413-743-2110 x303
m.lillpopp@diospringfield.org

Deacon Bruce Ziter
Permanent Deacon | Pastoral Minister
413-743-2110 x302
b.ziter@acparishes.org

Catholic Parishes of Adams & Cheshire - Baptism Intake Form

Description

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