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Sacramental Records - Certificate Request

- If you were baptized, received First Eucharist, were confirmed or married at Holy Name of Mary Parish, we are happy to supply a copy of your sacramental record.
- Information Needed
  
  The following information is needed in order to provide you a copy of a sacramental record. Please complete the form below to request your certificate!
  
  Determine what type of Certificate you need: Baptism - First Communion - Confirmation - Marriage
  
  Information about the individual on Record: First Name, Last Name & Maiden Name (if Married), Date of Birth, Year of Sacrament
  
  Parent's Information: Father's First Name, Last Name, and Mother's First Name, Maiden Name
- Request a Certificate
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Certificate Type (check all that apply) REQUIRED
  Please check all that apply.
  Baptism Certificate First Communion Certificate Confirmation Certificate Marriage Certificate Please fill out this field.
  
  Name of the Individual
  *Please use Maiden Name if applicable
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth for Certificate Record (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Approximate Year Sacrament was Received REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Name (First, Last Name) REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Name (First, Maiden Last Name) REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to this person REQUIRED Please fill out this field.
  
  If "other" please describe this relationship Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Reason for Requesting a Copy of the Certificate... REQUIRED Please fill out this field.
  
  Submit
  
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