Welcome to
 St. Clement of Rome Parish
 One of the 100 Great Catholic Parishes of the United States
4317 Richland Avenue, Metairie, Louisiana 70002  |  Phone (504) 887-7821  |  Fax (504) 454-3906  |  stclement@archdiocese-no.org

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Baptismal Form
(please print)

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Father's Full Name: _______________________________________________________

Is Dad Catholic? _____(y/n) If Not, What Religion? ________________________

Was Baptized? ___________(y/n) Was Confirmed? (y/n) _______________________

Mother's Full Name (Include Maiden Name):__________________________________

Is Mom Catholic? ______(y/n) If Not, What Religion? _______________________

Was Baptized? ____________(y/n) Was Confirmed? ____________________________

Family Address: ___________________________________________________________

City ____________________________________ State _________ Zip _____________

Family Telephone: _________________________________________________________

Are You a Member of St. Clement of Rome Parish? ______________________ (y/n)

Do You Receive the Church Bulletin? ___________________________________(y/n)

Do You Receive the Church Envelopes? ___________(y/n) Envelope # __________

Place Where Married:_________________ Name of Celebrant:___________________

If Not Married in Catholic Church, Give Reason . . .
Use Back of Page — Do Not Use Great Detail.

Full Name of Child: _______________________________________________________

Birthday: _____________ City and State of Birth:___________________________

First and Last Name of Godfather:__________________________________________

Godfather's Religion: _________ Church He Attends _________________________

Is Godfather a Practicing Catholic? ______ (y/n)

First and Last Name of Godmother: _________________________________________

Godmother's religion: ___________ Church Attends: _________________________

Is Practicing Catholic: ______ (y/n)

When are you expecting to baptize your child? Give Month and Year:_________

Do you have other children? If yes, list their first names and their ages:

__________________________________        _________________________________

__________________________________        _________________________________

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