formulir pendaftaran baptis dewasa

Jalan Melawai Raya No. 197, Kebayoran Baru - JAKSEL 12130
Telephone : 021-7220763 - Fax: 021-7220558
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FORMULIR PENDAFTARAN BAPTIS DEWASA
(untuk yang berasal dari luar paroki Blok B)
Nama lengkap

: ...........................................................................................

Tempat/tgl. Lahir

: ...........................................................................................

Alamat lengkap

: ...........................................................................................

Telpon dan HP

: ...........................................................................................

Nama Lengkap Ayah

: ...........................................................................................

Agama Ayah

: ...........................................................................................

Nama Lengkap Ibu

: ...........................................................................................

Agama Ibu

: ...........................................................................................

Jika telah menikah:
- pernikahan yg sekarang merupakan pernikahan yg ke-berapa?
: ...........................................................................................

- nama suami/istri

: ...........................................................................................

- agama suami/istri

: ...........................................................................................

- tempat/tgl pernikahan

: ...........................................................................................

- dengan cara apa?

: Sipil / Adat ……… / KUA / Gereja Kristen / Gereja Katolik
(coret yg tdk sesuai)

Secara singkat, tuliskan motivasi Anda mengapa ingin dibaptis Katolik?
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Jakarta, ................................
Mengetahui:

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--------------------------------------------------------------Katekis