Baptismal Certificate Request Form

Donation Amount:

€ 5.00

Please note: we ask a €5.00 donation per certificate.

Full name given at Baptism

Date of Birth

Date of Baptism (Month, Year)

Halston Street Parish Church St. Mary of the Angel's, Church Street St. Paul's Arran Quay

Parents Names

Father

Mother

Godparents Names

Names

Certificate requested by

Name

Address

Phone Number

Mine Parent Grandparent Other (Please Specify)

Other Relationship

Payment Information

First Name *

Last Name

Email Address *

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Donation Total: €5.00