EmailMe Form - St. Peter's - Sacramental Certificate Request Form

Name of Person Making Request *

First Last

I am the same person named in the certificate: *

Yes

Legal Guardian (under-age request)

Only the person named in the certificate or their legal guardian (if the person named in the document is currently under 18 years of age) may pick up the document.

Email *

You will be emailed at this address when your request is received, and when the document has been processed. Please check it often, and look in the spam catcher.

Daytime Phone *

### - ### - ####

Name of Person on Certificate *

First Last

Type of Certificate *

Baptism

Confirmation

Catholic Marriage

Date of Birth of Person on Certificate *

MM / DD / YYYY

Date or Approximate Date Sacrament Received MM/DD/YYYY *

Parent (Father) *

First Last

Parent (Mother) *

First Last

Mother's Maiden Name *

REQUESTING MARRIAGE CERTIFICATE: Please provide names of bride (maiden name) and groom as they would have appeared at time of marriage.

I acknowledge that St. Peter's, in complying with privacy law, cannot email or fax a copy of the certificate to me. *

I have read this

(Please select one) The certificate should be... *

picked up by the person named in the document (or their legal guardian if under 18 years of age) at St. Peter's parish office. ID REQUIRED.

sent directly to the Requesting Parish or School (I do not need a copy of the document). Enter information below.

sent to my current Home Parish for pick up by the person named in the document (or their legal guardian if under 18 years of age). ID REQUIRED. Enter information below.

St. Peter's Parish Office regular hours of operation are 9:00am - 3:00pm, Monday to Friday. Our office is located at 511 Cheapside Street, London, ON N5Y 3X5 (c/o St. Michael's Parish).

Name of Requesting Parish or School

City Where Parish or School is Located

Name of Contact at Parish or School

Mailing Address of Parish or School

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region