Baptism Enquiry – St Nicholas of Myra Penrith

Proposed Month of Baptism:*

Please nominate a proposed month, we will contact you by phone to discuss available dates in that month.

Child Details

Child's Name*

First Last

Date of Birth*

Gender*

Father's Name*

First Last

Father's Religion*

Please specify which religion / denomination*

Phone number*

Mother's Name*

First Last

Mother's Maiden Name

Mother's Religion*

Please specify which religion / denomination*

Phone number*

Email*

Address*

Street Address Suburb State / Province / Region ZIP / Postal Code Country