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

Have already spoken to Pastor Kevin regarding baptism?

		Yes
		No

* = Input is required