Baptism

Date for Baptism (Please give 3 weeks advance notice)

mm/dd/yyyy

Worship Hour (not when communion is scheduled)

Which Chapel?

		Chapel East
		Chapel West

Full Name of Person to be Baptized *

Place of Birth (city & state) *

Birthdate *

mm/dd/yyyy

Full Name of Father

Full Name of Mother

Name of Person Completing This Form *

Street Address of Person to be Baptized *

City *

State *

Zip Code *

Telephone Number *

Name of Sponsor (Godparents)

Address of Sponsor

Name of Sponsor (Godparents)

Address of Sponsor

Name of Sponsor (Godparents)

Address of Sponsor

If you have already spoken to a pastor regarding baptism, who did you speak to?

		Pastor Mike Brewer
		Pastor Kevin Austin

* = Input is required