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Baptism Form
Date of Baptism
Time of Baptism
Which service would you like to have the baptism - or, let us know if you'd like to have it outside of a regular service.
Please Select
Sunday Traditional Service
Sunday Contemporary Service
Wednesday Blended Service
Other Time (please specify below)
Other Baptism Time
If you selected "other time" above, please tell us when you'd like to have the baptism.
Full Name of Person to Be Baptized
Birth Date
City of Birth
Mother's Full Name
Mother's Birth Name
Father's Full Name
Sponsor's Names
Please use a separate line for each certificate.
Current Address (Street, City, State, Zip Code)
Phone number
Email
*
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