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Sacrament Record Request

- Please fill the Sacrament Request form Accordingly
  
  For any questions or concerns please contact our parish office at 410-686-3085.
  Please allow at least 1 weeks' notice to receive a certificate.
- This form is not accepting responses at this time.
  
  Name of Person Requesting the Certificate REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to person whom the certificate is for REQUIRED Please fill out this field.
  
  Name of the Person whose certificate is being requested (Last, Middle, & First Name) REQUIRED Please fill out this field. Please enter valid data.
  
  Certificate Requested REQUIRED Baptismal Certificate First Communion Certificate Confirmation Certificate Marriage Certificate Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Date the Sacrament was received (Approximate date if exact date is unknown) REQUIRED Please fill out this field. Please enter valid data.
  
  Requestor's Email Address REQUIRED
  This Email address will be receiving a copy of the certificate
  Please fill out this field. Please enter an email address.
  
  Requestor's Address
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  How would you like to receive the certificate REQUIRED Please fill out this field.
  
  Name of Church requesting Certificate REQUIRED Please fill out this field. Please enter valid data.
  
  Church Street Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Additional Comments
  
  Submit
  
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Our Lady Queen of Peace

Middle River, MD

Sacrament Record Request

Please fill the Sacrament Request form Accordingly