* indicates a required response
Child Information
Child's First Name:*
Child's Middle Name(s):
Child's Last Name:*
Date of Birth:*
Place of Birth:*
Male / Female:*
Male  Female

Parent Information
Mother's First Name:*
Mother's Last Name:*
Mother's Religion:*
Mother's Maiden Name:*
    
   
Father's First Name:*
Father's Last Name:*
Father's Religion:*
Are you currently members of Good Shepherd?* Yes  No
Home Phone:* Other Phone:

Email Address:

GodParent Information
(Please keep in mind that Godparents must be Catholic)
Godmothers Name:*
Godfather's Name:*

Other Information
Which upcoming Baptism date are you interested in?
Any other information you would like us to know?

This information will be emailed to Deacon Gene Christensen. Please feel free to call him at: 262-255-2035.
He will contact you shortly with other information. Thank you!