Visitation Parish
Record & Document Request Form

• Please provide the following  information on how to contact you:

  First Name
  Last Name
  Middle Initial
  Street Address
  Address (cont.)
  City
  State/Province
  Zip/Postal Code
  Country
  Work Phone
  Home Phone
  E-mail

Name on Document(s)
Approximate Date(s)

Select as many of the documents you need:

Baptismal Certificate                    
First Communion Certificate                     
Confirmation Certificate                
Marriage Certificate

Other  
Describe Other: