Request a Baptism

Baptism Request Form
To request a baptism, please complete the following information. Please check your spelling for accuracy, as it will be used on certificates. The church office will verify the date via email or phone.

Select a contact *

Contact Information of Person Requesting Baptism

Name

Email *

Daytime Phone *

Information about Baptismal Candidate

Candidate's First, Middle, Last Name, Suffix for Certificate: *

Birth Date: *

Location of Birth (City, State):

Mother's Full Name for Certificate:

Father's Full Name for Certificate:

Requested Date for Baptism: *

Sunday Worship Time: *

10:00 am Sunday

Baptismal Sponsor(s)/Godparent(s):

Notes

Mailing Address

Apt, suite, etc.

Country

City

State

Zip code

Captcha *

For security verification, please enter any random two digit number. For example: 31

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