Sponsor Certificate Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address 1 REQUIRED Please fill out this field. Please enter valid data.

Address 2 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.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email Address REQUIRED Please fill out this field. Please enter an email address.

Confirm Email Address REQUIRED Please fill out this field. Please enter an email address.

Parish Affiliation REQUIRED I am a registered member of St. Rose of Lima Catholic Church in Gaithersburg, MD Please fill out this field.

I have been asked to be a sponsor for an individual who is: REQUIRED Being Baptized Being Confirmed Please fill out this field.

Eligibility: REQUIRED I am a Catholic who has been baptized, confirmed and has received the Sacrament of Holy Eucharist and at least 16 years of age. Please fill out this field.

Marital Status: REQUIRED I am single I am married within the Catholic Church Please fill out this field.

Relation to the candidate: REQUIRED I am not the mother or father of the one to be baptized or confirmed. Please fill out this field.

Intention: REQUIRED I live a life of faith in keeping with the function to be taken on, and I intent to help the candidate to lead a Christian life in keeping with the baptismal promises and to fulfill faithfully the obligations inherent in it. Please fill out this field.

I am requesting REQUIRED The Sponsor Certificate to be mailed to the address above I will contact the parish office before coming to the office to physically picking up the certificate Please fill out this field.

By clicking the "Sumit" button, I certify that all the information presented in this form is true and correct, and I understand that this form is not a valid sponsor certificate, but only an applicaton that will help my pastor determine my eligibility.

I Agree Please select this field.