Sacrament Certificate Request Form

I, the requestor, am REQUIRED An adult requesting my own certificate The parent of a child currently under the age of 18 Please fill out this field.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED

Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Name on Certificate (full legal name) REQUIRED Please fill out this field. Please enter valid data.

City/State of Birth REQUIRED Please fill out this field. Please enter valid data.

Reason for Request and who can request the certificate: REQUIRED For my records (for minor child or an adult for self; specify sacrament type on next question) I am getting married (adult) (Baptism certificate with notations) For annulment purposes (adult) (specify type below) I am preparing to receive Eucharist and Confirmation (adult-Baptism with notations) My child is preparing to receive First Communion (parent) (Baptism only) My child is preparing to receive Confirmation (parent) (Baptism with notations) Please fill out this field.

Type of Certificate Needed: Baptism Certificate "with notations" ("with notations" means that the Baptism certificate will include any/all sacraments that we have in our records) First Communion Certificate only Confirmation Certificate only Marriage Certificate only

To receive my completed certificate(s) I will pick up at the parish office of St. Catherine of Siena Catholic Church Mail to a parish office outside of the Diocese of Austin

To mail, enter name of Parish, address and point of contact (type N/A if you are picking up your certificate) REQUIRED Please fill out this field. Please enter valid data.

Email address for contact at parish (type N/A if picking up your certificate) REQUIRED Please fill out this field. Please enter valid data.

With thousands of listings of sacraments received at St. Catherine of Siena Catholic Church, we need your assistance to locate the correct information to create the certificate. Please complete all the information to expedite the search. Thank you.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Date of Sacrament REQUIRED Please fill out this field. Please enter valid data.

Mother's Full Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Father's Full Legal Name REQUIRED Please fill out this field. Please enter valid data.

Godparent #1/Sponsor Name REQUIRED Please fill out this field. Please enter valid data.

Godparent #2/Sponsor Name REQUIRED Please fill out this field. Please enter valid data.

Name of clergy who issued Sacrament REQUIRED Please fill out this field. Please enter valid data.